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SAND LAKE #2 BLK 6 LT 1
Onsite File Sand Lake #2 Block 6 Lot 1 #011-133-36 Nov -09-2022 04:57 PM Anchorage Well & Pump Service Inc 9072430742 #2845 P 1/ 1 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: Parcel Identification Number: 011 _ 133 - 3 Date of Issue: - - Legal Description Block Lot Property Owner Name & Address: SANDERS MELISSA MARIE & RYAN JOHN SAND LACE #2 6 1 8201 SEAVIEW ST ANCHORAGE, AK 99502 Pump Installation Date. 11 - 08 _ 2022 Pump Intake Depth Below Top of Well Casing:.-.... 220 feet Pump Manufacturer's Name: REIN -JACKET Pump Madel: 25S17 -300C311 Pump Size: 3.00 hp IPitless Adapter Burial Depth: 12 Pitless Adapter Manufacturer's Name: I Pitless Adapter Installer: feet BAKER Well Disinfected Upon Completion" X Yes ❑ No Method of Disinfection. PELLETS Comments: Pump Installer Name: _ ANCHORAGE WELL & PUMP SERVICE Company: --._-- -. .. 7640 KING STREET ANCHORAGE, AK 99515 Mailing Address: 907-243-0740 City: State: Zip: Attention, The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201484 PID Number: 011-133-36 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Fm� Upgrade Name LARRY &PAULA JACKSON ABSORPTION FIELD 9 Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 8201 SEAVIEW ST ANCHORAGE, AK 99502 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-351-6648 3 1.2 GPD/SF 11.8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.8 Ft. Gravel depth beneath pipe 7.0 Ft. Subdivision Block Lot SAND LAKE #2 6 1 Fill added above original grade 0.0 Ft. Gravel length 27.0 Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches 1 Dist. between trenches From Tank Field Tank Line 378 Ft N/A Ft. Well >100' >100' N/A N/A >25' TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity GREER 1000 Gal. Surface Water >100' >1 00' N/A N/A Material PLASTIC Number of compartments 2 Lot Line >5' *>4' N/A N/A NA Foundation >1 0' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Remarks *LOT LINE WAIVER OSV201081 Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer NORTHERN EXCAVATING Drainfield D3034 CO/MTD3034 Inspector L.TIDWELL BENCH MARK (Assumed elevation) 100 ft Inspection 1st 12/11/20 12/11/20 Location and description dates: 2�d BOTTOM OF SIDING 3"d 12/12/ 4" 12/12/26 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 44 too °"'••qS ®� Conditional Approval: Date ®�P..•... 49th �vv.v..'v 3a..u� ..uva a.m se.es.oafg+¢j �jj� ® u...na.........uv...............ovu.... �°MICHAEL E. ANDERSON Septic System � CAnx � �No. t Approved � X Date 3 ao2 i ®'s °°^°°7/20/210/21 .•>•°'F=C� 410 7/20/21 47P Note: this approval does not include well permit requirements. tKev ubluzri u/ // 1"=50' 3-BDRM HOME CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP201484 PID # 011-133-36 SAND LAKE #2 SUB, BLOCK 6, LOT 1 A B MH 38.1 SV 42.6 2CO 43.6 A B DV 44.9 CO1 61.7 MT1 62.0 CO2 55.2 23.8 28.7 30.0 31.5 47.8 48.2 55.2 WEST 82nd AVENUE FEET 0 50 100SEAVIEW STREETCLASS 'C' WELL W/ 100' RADIUS CLASS 'C' WELL W/ 100' RADIUS 27' LONG x 3' WIDE x 7' EFFECTIVE DEPTH ABSORPTION TRENCH 2COSVMHCO1 CO2 MT2 EXISTING ABSORPTION TRENCH EXISTING ABSORPTION TRENCH 160 CLASS 'C' WELL W/ 100' RADIUS 10' ELECTRICAL EASEMENT NEW 1,000 GALLON SEPTIC TANK w/20" MANWAY. DESIGN TEST HOLE 4' 6'8'DV155 PLAN AS-BUILT 7/20/21 TH1 MT2 55.855.7 CO3 40.628.3 CO3 MT3 PROFILE AS-BUILT (NO SCALE) 94.4 90.0 94.9 99.5FCOMH SV1000 GAL SEPTIC TANK 2CO94.2 7/20/21 98.4 FINISH GRADE DRAINFIELD ROCKMT193.6 CO1CO293.6 98.4 ORIGINAL GRADE MT227' 86.686.6 TH#1NO GROUNDWATER 12/22/21 79.9 PERMIT # OSP201484 PID # 011-133-36 SAND LAKE #2 SUB, BLOCK 6, LOT 1 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME(minutes)NET TIME(minutes) DEPTH toWATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) SAND LAKE #2 SUB B6 L1 7/20/21 l.tidwell DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH?n/a ---- ---- 011-133-36 larry jackson 2' OB Professional Engineers Stamp: no 0" 12/22/21 16.5' SP 7/20/21 TEST HOLE TO CONFIRM NO IMPERMEABLE LAYER OR GROUND WATER W. 82nd AVENUE (i -EDGE OF ROAD \ S 89'55'E 135' 5.1'x9.2' CANT COVERED10.1'x10.1' DECK 7.7 ' CAN \SHED 41.5' ?0 C Lot 1 3.1' CANT ;� �Q n I 6,750 S.F. 0 OP BI—LEVEL17'5 f SEPTIC - RESIDENCE 6.1, ��� PIPES �---�� DECK RAMP N 89'55'W 135' / Ui Lot 2 / 100' PROTECTIVE / WELL RADIUS �j F,- - F_ WOODEN FENCE Iq �� Lot 24 JiN IO WOODEN FENCEFENCE Lot 23 10' T&E EASEMENTS NOTE: THERE ARE NO BEARINGS ON THE RECORD PLAT. BEARINGS SHOWN HEREON ARE FROM THE SLIM PLAT OF SECTION 10, T12N, R4W, SEWARD MERIDIAN, ALASKA, ACCEPTED MAY 12, 1952. DISTANCES ARE HELD FROM THE RECORD PLAT No. P-176. MORTGAGE SURVEY _x_ SCALE _ 1=_= 30'_ GRID __2_2224_ Project No. ___ 21_107LR1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone 0000�p�0 (907) 522-4625 Fax Professional Land Surveyors ken®langsurvey.com o ,. OF qQ jonathan®langsurvey.com �oP . IIS" �4 I hereby certify that I have surveyed the following described property: LOT 1, BLOCK 6, SAND LAKE SUBDIVISION No. 2 (PLAT No. P-176) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained hereon shall not be used to establish any fence, structure, or other improvements. Dated this the _ Day of IYy,i '.l -t -------- LIL__, at Anchorage, Alaska 4IT- 9TH*� ................ .GtV........... KENNETH�GF Li�IG o S 202.- 0 i F •.•CCC -5522.' gJpG \O aR ....... �pvp VOA �FESSIONA� �o 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. AECC963 r WELL Z i O - -. - 1.5' CANT N -. '. ASPHALT. DRIVEWAY U 29.1'.._:. W. 82nd AVENUE (i -EDGE OF ROAD \ S 89'55'E 135' 5.1'x9.2' CANT COVERED10.1'x10.1' DECK 7.7 ' CAN \SHED 41.5' ?0 C Lot 1 3.1' CANT ;� �Q n I 6,750 S.F. 0 OP BI—LEVEL17'5 f SEPTIC - RESIDENCE 6.1, ��� PIPES �---�� DECK RAMP N 89'55'W 135' / Ui Lot 2 / 100' PROTECTIVE / WELL RADIUS �j F,- - F_ WOODEN FENCE Iq �� Lot 24 JiN IO WOODEN FENCEFENCE Lot 23 10' T&E EASEMENTS NOTE: THERE ARE NO BEARINGS ON THE RECORD PLAT. BEARINGS SHOWN HEREON ARE FROM THE SLIM PLAT OF SECTION 10, T12N, R4W, SEWARD MERIDIAN, ALASKA, ACCEPTED MAY 12, 1952. DISTANCES ARE HELD FROM THE RECORD PLAT No. P-176. MORTGAGE SURVEY _x_ SCALE _ 1=_= 30'_ GRID __2_2224_ Project No. ___ 21_107LR1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone 0000�p�0 (907) 522-4625 Fax Professional Land Surveyors ken®langsurvey.com o ,. OF qQ jonathan®langsurvey.com �oP . IIS" �4 I hereby certify that I have surveyed the following described property: LOT 1, BLOCK 6, SAND LAKE SUBDIVISION No. 2 (PLAT No. P-176) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained hereon shall not be used to establish any fence, structure, or other improvements. Dated this the _ Day of IYy,i '.l -t -------- LIL__, at Anchorage, Alaska 4IT- 9TH*� ................ .GtV........... KENNETH�GF Li�IG o S 202.- 0 i F •.•CCC -5522.' gJpG \O aR ....... �pvp VOA �FESSIONA� �o 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. AECC963 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://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201484 Work Type: Septic Upgrade Tax Code Number: 01113336000 Site Legal Address: SAND LAKE #2 BLK 6 LT 1 G:2224 Site Mailing Address: 8201 SEAVIEW ST, Anchorage Owner: JACKSON LARRY D & PAULA C Design Engineer: FORGE ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank Holding Tank Privy Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: 12/7/2020 12/7/2021 6750 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: Issued By: Date: Date: I Z- 17110 3 12.8.20 Municipality of Anchorage Sf P.O. Box 196650 m 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Proaram * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV201081 COSA#: Permit#:OSP201484 PID#: 011-133-36 Legal Description: Sand Lake #2 Blk 6 Lt 1 Engineer: Forge engineerinq Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 4.0 feet to the south property line and 6 feet to the east property line. In addition, the new trench may be 9 feet from the existing crib. 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. ................................. 0 E X E Z R ...... 0 0 t t t ... t ........... X 0 0 0 0 ... t. X t Waiver is Granted: X Waiver is not Granted: Date: 12-41A v Approved by: LZ Name of Review ........................................................... 0 ■ 0 0 0 0. t. t t 0 0 0 0 .. ■ **** VARIAN C E/WAIVER REVIEW **** 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. 011-133-36 Property owner(s) Larry & Paula Jackson Mailing address 8201 Seaview Street Anchorage, AK 99502 Site address Same Day phone 351-6648 Legal description (Sub'd., Block & Lot) Sand Lake #2, Block 6, Lot 1 Legal description (Township, Range & Section) Lot Size 6,750 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank 1KUpgrade ❑X Duplex ElHolding (D) Tank F-1Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Lot Line Distance: 4' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. a Qt'-Zq� (Signature of property owner or authorized agent) Permit/Rush Fees: -# q 6.2_5 CO✓Ip Date of Payment: 1 f a DQ b Receipt Number: 0'/0 4 4D Permit No. 0_5PZ01Lj8(-[ Permit App__- : ._.,:c Waiver Fees: 4168.7-5 CDUID Date of Payment: 1 l I 1 a O a C) Receipt Number: bl) ['-I �( Waiver No. nSU 20 100 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) December 7, 2020 M.O.A. Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: Sand Lake #2, Block 6, Lot 1 – 8201 Seaview Street Septic System Design Dear On-Site Services Engineer: The septic system on the subject lot has failed and must be replaced immediately. We are submitting this permit application for the construction of a septic system. The attached site plan identifies the location of the home and the existing well and septic system. The proposed septic system is also shown. No conflicts exist between this proposed well and system and any other well or septic system on this lot or adjacent lots. The lot is only 6,200 square feet in size which limits the area available for a septic system upgrade. The existing well on the lot further limits the locations available. The subsurface soils in the area are composed of clean sand with percolation rates between 1 and 5 minutes per inch as evidenced by tests completed on adjacent lots. We anticipate the organic layer to be 1’ based on visual observations underlain by clean sand with no groundwater. A new test hole will be placed prior to construction to verify design parameters. We request a condition to the permit be added requiring the test hole. The existing absorption pit is approximately 9’ from the edge of the proposed absorption trench. The pit will be connected to the new system with a flow diverter valve for future use if necessary. We request a waiver to reduce the separation distance between the trench and pit to 9’ from 14’. The subsurface soil is very clean sand and the septic effluent will be absorbed downward. Very little migration in a horizontal direction is expected. The location of the new absorption trench is 4’ from the lot line to the south and 6’ from the east lot line. A Lot Line Waiver is required. The absorption trench on the lot to the east will be 14’ from the new absorption trench location. The absorption trench to the south is more than 35’ from Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201484, Deb Wockenfuss, 12/07/20 the proposed trench. We therefore request a Lot Line Waiver be issued to allow the proposed absorption trench to be constructed at the planned location. The surface area on the lot slopes in varying directions, but primarily to the northeast at approximately 8%. The absorption trench will be aligned slightly out of parallel with the ground surface contours. The south end will be approximately 1.5’ lower than the north end. The effluent delivery line will be placed at 3.5’ below the surface at the low end for a total depth of 10.5’ and 2’ below the surface at the high end for a total depth of 9.0’. The effective depth of the absorption trench will not be out of the accepting soil layer at either end. Ground contours are shown on the site plan indicating 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, but the alignment is limited by the surface area available. The distribution line is designed at 3.5’ below the surface and the trench will remain entirely in the accepting soil layer over its 27’ length. The new system will be a minimum of 100’ from all Class C Wells and 100’ from any surface water. The absorption trench will also be more than 5’ from the proposed septic tank location which will be at or near the existing tank location. Please refer to the attached test hole logs and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, P.E. 12/7/20 // 1"=50' 3-BDRM HOME NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND SAND LAKE #2, BLOCK 6, LOT 1 WEST 82nd AVENUE 12/7/20 FEET 0 50 100SEAVIEW STREETSHED CLASS 'C' WELL W/ 100' RADIUS CLASS 'C' WELL W/ 100' RADIUS DECOMMISSION EXISTING SEPTIC TANK PER U.P.C. PROPOSED TEST HOLE. MINIMUM DEPTH 16.5'. 27' LONG x 3' WIDE x 7' EFFECTIVE DEPTH ABSORPTION TRENCH 2COSVMH CO CO MT EXISTING ABSORPTION TRENCH EXISTING ABSORPTION TRENCH 160 CLASS 'C' WELL W/ 100' RADIUS 10' ELECTRICAL EASEMENT NEW 1,000 GALLON SEPTIC TANK w/20" MANWAY. DESIGN TEST HOLE 4' 6' 8'DV 155 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201484, Deb Wockenfuss, 12/07/20 SAND LAKE #2, BLOCK 6, LOT 1 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: 1-5 MIN/IN APPLICATION RATE: 1.2 GPD/SF 7' DEEP TRENCH SYSTEM 1,000-GALLON SEPTIC TANK TYPICAL TRENCH SECTION (NO SCALE) 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 3' 6" 6" 3' 7' 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 BOTTOM OF TRENCH: 10.5' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE TOP OF TRENCH: 0.5' ABOVE GRADE 450 GPD / 1.2 GPD/SF /7' DEEP / 2 SIDES = 26.7 LF TRENCH REQUIRED (27 LF SPECIFIED) 11/19/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201484, Deb Wockenfuss, 12/07/20 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS b GENERAL CONTRACTORS 701 L lYOgt Moo. RM 101 ' M1G10·IOL MC 119507 · 9110. 4 90 )-! 1) 11· FK 1907 32445 · YF85fIL yan,Mq,ywYpcwn SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: -. SAND LAKE SUBDIVISION / 2: LOT 2, BLOCK 6. PERFORMED FOR: MELODY JACKSON DATE: 9/ 9/ 2004 DEPTH=_feet) TEST HOLE # 1 1== ORGANCS 2 5 6 ff DRY SOIL CLASSIFICATIONS 9/20/2004 CL OL MH CH OH 0. t GC Mae. GM SW SP SM SC 6' 1I.Sim 2 e ·°= o L f 4 1318- 4 1/ 6·· · ·· SP 9 ··· 10 ·: ·'·· eop:,· 11 '· ··· So 01, 12 ··`·· 13 ···· 11,· 14 · ·'·' 15 ·' ···· 16 B.O.H. 17 18 DEPTH TO GROUNDWATER DATE DRY 9/ 9/ 2004 DRY 9/ 20/ 2004 9/10/2004 1 25 vhlYxl J ff A. G ness. fesslot`oc DATE READING CLOCK TIME NET TIME MINUTES) WATER LEVEL READING NET DROP INCHES) 9/ 10/ 2004 1 9:25 6' 2 9:35 10 1 318- 4 1/ 8-8' 3 9:35 6· 4 9:45 10 1 318- 4 1/ 8" 5 9:46 6· 6 9:56 10 1 15/ 16" 4 1/ 16-16' 77 9:56 6· 8 10:06 10 2' 4' 9 10:07 6' 10 10: 17 10 2' 4' 11 10: 17 6' 12 10:27 10 2' 4' 19 PERCOLATION RATE 2.5 ( MIN./ INCH) PERC. HOLE DIA. 6 ( INCHES) TEST RUN BETWEEN 6.0 FT. AND 7.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN OSWALT COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 9/ 20/ 2004 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201484, Deb Wockenfuss, 12/07/20 21)2(1 -(I584(12 -I1 L Recording Dist: 301 - Anchorage S 12/7/2020 11:10 AM Pages: 1 of 4 • IIIIIIIIIIIIIIIIIIIIIIIIII 1203-1OB Grid 2224 EN20026 011-133-36-000 ENCROACHMENT PERMIT This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Larry D. Jackson and Paula C. Jackson (herein "Permittee"), whose address is 8201 Seaview Street, Anchorage, Alaska 99502. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Described in that certain written instrument recorded on the 11 `h day of March 1952, at Volume 69, Page 105, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, Described in that certain written instrument recorded on the 14`' day of April 1952, at Volume 70, Page 325, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The East Ten Feet (E10') of Lot One (1), Block Six (6), Sand Lake Subdivision No. 2, according to Plat Number P-176, filed on the 261h day of April 1950, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot One (1), Block Six (6), Sand Lake Subdivision No. 2, according to Plat Number P- 176, filed on the 26`h day of April 1950, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Third Judicial District, Seward Meridian, Alaska, (herein "Parcel"). Encroachment Permit - Page 1 of 4 eRecorded Document 2. Encroachment. Permittee will construct or purchased the following improvements on or within the real property subject to said Easement: A septic drain field with sewer cleanouts that encroaches approximately Four Feet (4') into the west side of said Easement for a distance of approximately Twenty-seven Feet (27), (herein "Encroachment") 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants Running with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. Encroachment Permit - Page 2 of 4 2of4 eRecorded Document 2020-058402-0 b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUG 'ELECTRIC ASS IATION, INC. By: Burke Wick, for Andrew Laughlin, VP Engr Date: % 2 f -J/die) PERMITTE By 2: XL ` -7arry . Jac, l son Date: Date: 1�7 0 .2 C% Encroachment Permit - Page 3 of 4 3of4 eRecorded Document 2020-058402-0 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this dlday of 2020, by Larry D. Jackson and Paula C. Jackson. ' N T Y _. JBLIQ STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) -a � F Notary Pubf' m and for the State of Alaska My commission expires: 01 -el( -2Z T e forego' g instrument was acknowledged before me -this day of ' 2020, by 1o5 uvk- 1✓l/ c� , Andrew Laughlin, VP Engineering of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. PUBLIC,/*,�� 'r�X!Y OF••���5`�t. AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Box 196300 Anchorage, Alaska 99519-6300 Notary Public -4n and for the State of Alaska My commission expires: -'r -V-ZZ Encroachment Permit - Page 4 of 4 4of4 eRecorded Document 2020-058402-0 GR€-:; R ANCHORAGE AREA BOR,_s GH e� Department of Environmental Qualit 3330 C Street /..ear Anchorage, Alaska 99503 �ldJ��mp1r INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME,/r 4uPz/"f!f. AILING ADDRESS PHONE LO ATIO1 LEGAL DESCRIPTION SEPTIC TANK: DISTANCE �� ® NUMBER OF FROM WELL6. MANUFACTURER 6e_'62 .. MATERIAL COMPARTMENTS INSIDE LENGTH 9 INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/LQ GALLONS. TOTAL LENGTH DISTANCE FROM WELL FOUNDATION u5 NEAREST LOT LINE Q/ OF LINES NUMBER OF LINES ABSORPTION AREA DISTANCE BETWEEN LINES DEPTH: TOP OF TILE TO FINISH GRADE TRENCH WIDTH_ IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE D-€�-CR 5"e y`Q' / / 7X J3 4/1 ee je/L H# ILE IN. AWVE TILE IN. WELL: - / y TYPE- / CONSTRUCTION / /4 14 -DEPTH DISTANCE FROM: BUILDING)I`� NEAREST %^ NEAREST e,'I- SEPTIC ,xdI SEEPAGE /00f FOUNDATION LOT LINE �fJ SEWER LINED, TANK ✓ , SYSTEM CESSPOOL , OTHER SOURCES APPROVED �DISAPP ROVED REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: C,4`57 LOT SLOPE: ,a -e REMARKS: Form EQ -032 DIAGRAM OF SYSTEM GREATER ANCHORAGE ARi ROOGH aac,wwea q - q au .� DEPARTMENT OF ENVIRONMENTAL QUALITY 3330"C" EET ANCHORAGE, ALASKA 99503 TE P -I ONE 274-4561 �%/L� y , ZG, I 1;077, •' SgR[O ISK'PJ SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION l'%.. '�/ MAILING ADDRESS INSTALLATION OF: SEPTIC TANK <-� SEEPAGE PIT TYPE AND SIZE OF FACILITY TO BE SERVED l� FINANCED THROUGH TO BE INSTALLED BY 7 SOIL TEST RES�7 l /yl - NOTE: THIS ULTS � COMPLETION DATE ANTICIPATED PERMIT N4 E 1p ONE DRAIN FIELD �v OTHER IS NOT VALID WITHOUT IL TEST (? 22-7S- FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SI TYPE MINIMUM DISTANCES, REQUIREMENTS Z FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT �. DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL r I SEPTIC TANK � SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK, ` �"/ SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DD)ESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REOUIR ENTS OF GREATER ANC DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. --/-T-' DATE APPLICANT'S SIGNATURE 1 14 %- SIZE —� TYPE DIAGRAM OF SYSTEM _ 28-68 AND THAT THE ABOVE a P T li I t( t -- U-- — J 'a' t 11L Tit _ 28-68 AND THAT THE ABOVE a P ulnncipaf ty.o Anchorage MEMORANDUM DATE: October 21, 1983 TO: Sewer and Water Staff and Files FROM: Cory Willis, R.S. (Ai SUBJECT: Sand Lake Subdivisions As of this date all on-site installation permits issued for lots in these subdivisions can be for no more than 2 bedroom, single family residences. This has come about per the request of Bruce Erickson, State DEC due to the large amount of high density development and the requests for waivers on Class "C" well requirements. CW78/ej/E2 91-010 (sna) �.l I 0. I✓ _f \ Q h O e 0 (33m),00'09-3 , 9000 S rn o (d)ll•05 p OLO lor, h CD B� 0 V ONas t 0 w ^ N as auk a CO 0 I -i O •r O i C ^U 0 U ' • � LP Q U ¢ O 7 ^ co CV) k 4�r ko � 0 r (p O O1 aim 0) x j 0) 0 �+ O ,8•£1 , c0 0.9 +' x o 0 � 0 O 0 � t ��,�''1,p .�e.. O_ C O a C o Q 0 �1 y C n O W Q, V V � B' k Cli y N Q. o CU ,, _' O m � � r y V j vL&J) N In W e' p� -Io `°�� 06�`cz '-s�� E QQ n y o c; o �e o _ -j -j O C m a` �� V V ?� � � V O V C .AjYa .• • yam© \ �r T;,., o • • ��� O N C � O O C ��oc`f �'•..••�(�4�q y a a• ` Vp C S � .� �cci 4 � st C o 0. I✓ _f \ Q h O e 0 (33m),00'09-3 , 9000 S rn o (d)ll•05 p OLO lor, h CD B� 0 V ONas t 0 w ^ N as auk a CO 0 I -i O •r O i C ^U 0 U ' • � LP Q U ¢ O 7 ^ co CV) k 4�r ko � 0 r (p O O1 aim 0) x j 0) 0 �+ O ,8•£1 , c0 0.9 +' x o 0 � 0 O 0 � t ��,�''1,p .�e.. O_ C O � C o Q Q y n O W Q, V V 1; CU ,, 1....,•4y� Q a v � u • 6 9i y V j N In W e' p� -Io `°�� 06�`cz '-s�� E n y o c; o �e o Q ._ o ,. a` �� V ?� ` .AjYa .• • yam© \ �r T;,., o • • ��� t3) � � ��oc`f �'•..••�(�4�q y a a• .0 a Vp C S � .� �cci 4 � to o a I it F{CU U t '1Z 0 a U) O . 2 � � Q �. O C y cp ft ll Cb SIN ,99 O � I(9 c O -QEO O O ONO M_ O M O a I ui Y �' , N O m 3 P I Lo 9L Y t� to W p U) 3 W 61 ,ObZ •'�, � 0 _' � O J O O O W J Z - 00 w WJ w a J h W v to m a •gyp O a w` L(j) ao,0£ 0 mZO'09 (3321) :Oa .. = = 3,90 0®s y e e_I a� ro ui ,I 0 0 o — 3 ,90 00 S 3AIU IUTASV3S SERVICE CONTRACT MULTI-FLO WASTEWATER TREATMENT PLANT THIS AGREEMENT MADE AND ENTERED into this _-!I:- day of 197-5—, by and between the user of a multi-flo, wastewater plant and ___� i_ the servicer, WITN hb THIS AGREEMENT is executed concurrently by the user and the dealer service manager at the time of installation. The dealer covenants and agrees to furnish twenty-four (24) months service on the user's waste treatment plant from date of installation. The purchaser -user . 17 covenants and agrees by the presents to, and does hereby contract with — to service the user's waste treatment plant upon . expiration of .the dealer's. aforesaid free service period of twenty-four (24) months. The user understands by signing this agreement that the user accepts responsibility for the service after the dealer free service period, and also understands e advised by the dealer. the necessity and responsibility for the service requirements that ar L Service Contract' - Continued Page Two inspection calls per ear at regular intervals and .ins e � 2 service a P y .his service guarantees to make two O P T_ `o an emergency calls for repair service. Unscheduled emergency or and to respond promptly � y g y p service calls not due to malfunction.of or defective sewage treatment units shall be paid for by the sewage treatment plant owner. Although the regular service and inspection calls during the first twenty-four (24). months of installation will be free to the sewage treatment plant owners, the sewage treatment plant owner shall be required to pay the Service .Contractor's road time for travel on an average scale computed by averaging road time. costs for the number of plant customers in the area of the service call. Inspection service calls. will include the following: l: An effluent duality inspection consisting of a visual check for color and examination for odors. 2. Adjustment and servicing of any mechanical and electrical components that are out of order. 3. iiackwashing of filter media or replacement of filtermediawith previously washed filters. 4. Periodic sampling, twice a year if necessary, of the effluent quality, and of the settled solids in the aeration tank. Any additional work necessary will be done upon written authority from the homeowner and at additional charge. Service from 7 ✓ -MONTH - DAY - YEAR - Service Call Cost $25.00 per call plus travel charges, if any. Customer's Name and Address 156 Accepted by Customer _ oA Service Represe /alive D OT FILL IN WATER {V DRILLERS LOG + r DrillingCo. Jones and Young Drilling CO., Inc. USGS No. Raymond Jones Area Driller Six -M Construction Co._ Use of well Residential Well Owner Location (address of: Township, Range, $ Section (if known); distance from road: k Lot 1 Blk 6, Sand Lake S/D No. 2 256 Ftfeet. Size of Casing-.-L—Depth of Hole 257 feet. Cased to . Static water level 127 feet QCT (below) land surface. Finish of well p (check one) open end (xxl: Screen ( ): Perforated ( ). Describe screen or perforations: er min for Inde_fin ours wit Well pumping test feetlof drawdown 2 gallons pfrom static level. No draw down Remarks Date completed WELL LOG Depth in faet from Give details of formations penetrated, size of material, ground surface color, and hardness. Q to 35 Gravel ��to�16 - Sandy Silt , 169 to 256 Cla 256 to 257Sand to to to to to to Ito to to to MUMCP�tLJTYO /' ECHO AGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 011-133-36 1. GENERAL INFORMATION Expiration Date: I ^ 10 20ZZ- Complata legal description Sand Lake #2 Sub B6 L1 Location (site address) 8201 Seaview St, Anchorage, AK 99502 Current property owner(s) Jackson, Larry & Paula Day phone Mailing address 8201 Seaview St, Anchorage, AK 99502 Real estate agent Stevi Alford 2. TYPE OF DWELLING: ❑® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 907-257-0118 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑■ Private Septic ■❑ Water Storage ❑ Holding Tank ❑ Community Well ❑® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $- G6 Waiver Fee $ _ Date of Payment 1 10//-3 1 ZZ/ Date of Payment Receipt Number C75-7 3 r / Receipt Number COSA # 03C-9-1 i t? 10 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 10/12/2021 TH .. ... 6. DSD SIGNATURE .' t System #1 Approved for 3 bedrooms B . enjam(n.5chiller CE 1292 System_#2 Approved for bedrooms ����srFq. , 101252 -�/ Disapproved �1lF�pROFESSO Conditional approval for bedrooms, with the following stipulations: OF - c� R AND �o WAS ��IAT 0�=. J T ,_ J `�J - ENT SERN\G BY �— Original Certificate Date:�— 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 Checklist blue sheet COSA Checklist Legal Description: Sand Lake #2 B6 L1 Parcel ID: 011-133-36 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA Fg-1 Well log is filed with Onsite (or attached) Well production at time of test 3.8+ gpm Date drilled 1976 Water storage tank volume gallons Total depth 257 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 256 ft 9 Coliform bacteria is Negative On Sanitary seal is functioning correctly Nitrate mg/L ®❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic 78.0 ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 8* in. Collected by Forge Engineering Date of flow test for COSA 10/6/21 Date of Sample 9/29/21 Static water level at beginning of test 122 ft. Comments (*Well is a previous Class C well that serves three properties and is not subject to COSA requirements.) B. TANK DATA Age of tank(s) <1 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank ro-1 Standpipes/foundation cleanout per record drawing Date of pumping New D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 12/11/20 FE -1 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 0 Monitor tubes go to bottom of effective. If not, state depth into effective ❑® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: New Absorption Trench COSA Checklist yellow sheet C. LIFT STATION ❑ ' ed maintenance completed Age of lift statio years Lift station material Comments: Adequacy test date esults ❑ Pass For bedrooms Fluidrior 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) Septic Tank/Lift Station on Lot > 100' Yes Community Sewer Manhole/Cleanout > 100' ft ❑✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' F-(1 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' E] Yes if No ft Holding Tank > 100' [D Yes if No ft Neighboring Absorption Fields > 100' Water Service Line > 10' ❑✓ Animal Containment > 50' Q Yes if No ft ft 0 Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 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' 0 Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' © Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ 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 ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes . if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' ✓❑ Yes if No ft F. ENGINEER'S COMMENTS *Lot line waiver #OSV201081 G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet 49 ' • , �...._ ..�/........... Benjanyg.&hiller �¢ �'�� • CE 12592 • �`�i �Jl " 10/12/21 • "U� �ki,2'pROFESStONP� DEVELOPMENT SERVICES DEPARTMENT On -Site water and wastewater Section www.muni.org/onsite 907-343-7904 f` Fax: 343-7997 Arsenic Advisory Certificate of On -Site Systems Approval # osc211610 Subdivision: Sand Lake #2, Block 6, Lot 1 A water sample revealed -an arsenic concentration of 78 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. MaiUn'g Address P O Box 196650 *Anchorage,Alaska 995'19-6650'*" murn org ITY DEPARTMENT OF HEALTHLAND ENV RONOME TAL PROTECTION 1rG DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township; range) .0 / & 6 .S,�'WdL4Xd' Location (address or directions) F2 01 SeAv; e w (b) Applicant Name 1',4v/,4 /J4C9Xd AA Telephone: Home a d3' 55S 9 Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder 0 ; Buyer ❑ ; Other ❑ (explain); o (d) Lending Institutin L F—fA. Cr Old I^�,\ Telephone Z 0 0 Address Yo oo CX`t°C c (1-1 (0--71- I f (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following. -address*.. 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must havewritten confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL OnsiteX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 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 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 dexs� -��-r � s Telephone } �y9' �O f�S Address ...220 �" FP¢4 Awe �i . /Y/�. 5; 9 O % Date goo, �ngin 5 1°ap o ® *a a coca 0400 000840000 ° p • ares$ API AF'As w° e 0 0¢® e vo a Care . Meye 353 �o ��100 FESSI 6. DHEP APPROVAL 7 Approved for i' ),3 bedrooms Approved X' Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. Employees, 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION nL� 1 RECEIVED A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Legal Description: �� ^'� /�i'[e Al 0, L Zo Wail r accif6-aiinn r /'7'(/'4 / e If A. R. C. D.E.C. Annrnved fY/Nl Al,___—_ Well Log Present (Y/N) _y Date Completed % �'-1Yield 2 9/00 — toc/140� Total Depth 2,5- % P Cased to 2 �� ® Depth of Grouting ;vA, Static Water Level 12 Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N)� Electrical Wiring in Conduit (Y/N) Z Depression Around Wellhead (Y/N) ",IV Separation Distances from Well: i To Septic/Holding Tank on Lot % On Adjoining Lots �� r To Nearest Edge of Absorption Field on Lot ——; On Adjoining Lots ✓ DAY To Nearest Public Sewer Line N, A To Nearest Public Sewer A. Cleanout/Manhole To Nearest Sewer Service Line on Lot A. Water Sample Collected by _/.rs' d- 4© Date )1-91 L Water Sample Test Results 9 13 4e /®r X Comments Sec .4114c -4J well Aa%, w2 Ice, -57t cc.r-a/ t"d w</1 Ae r7- /a7 -V-515E ArMACH60 VJAVr . QL)V5io - B. SEPTIC/HOLDING TANK DATA Date Installed �� �% Size10D0M2 No. of Compartments i Standpipes (Y/N) Air -tight Caps (Y/N) —1 Foundation Cleanout (YIN) —y Depression over Tank (Y/N) Al Data Last Pumped 1 7/- Pumping/Maintenance Contract on File (Y/N) �-_b U� +— - ; for _ Holding Tank High -Water Alarm (Y/N) Al Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Weli O --To Building Foundation. 7_. To Property Line —_ %O To Disposal Field To Water Main/Service Line IV- 7 . To Stream, Pond, Lake, or Major Drainage Course _--sem f7 Comments sae�9i✓Ac- J aP�� � �� �'� P ee;,0 7 d Sic 4f//1--!0 rotl4e �c Cr i,2, i�=s /'3 �aneVc�/s'ou.lr Page 1 of 2 72-026 fPev 8/861 Fron: C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata/ Type of System Design f ccs, 9g e Date Installed sl o 6 Length of Field Width of Field Ala Depth of Field � Gravel Bed Thickness — 6 V Square Feet of Absorption Area t��' Standpipes Present (Y/N) / Depression over Field (Y/N) N / Date of Last Adequacy Test 1_2 //ZR( Results of Last Adequacy Test SA �is-1 Ac }�s�y � 3 &)t—ams Separation Distance from Absorption Field To Water -Supply Well To Property Line To Building Foundation Z Z Lot On Adjoining Lots To Existing or Abandoned System on r To Water Main/Service Line To Cutbank (if present) ti To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area d Comments _ A=1`171t'LD VAf'1AiM', C?UOU'l D. LIFT STATION nstalled Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for __ Electrical Codes (Y/N) - -- - Comments Dimensions Manhole/Access (Y "PumD-Off"Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Cycles during Adequacy Test. Meets MOA I certify that I have ch cked, v rlfiiedo conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed 4� ''+� ' Date z Company sse �p5 d `o7%�� MOA No. Receipt No. Date of Payment e Amount: $ �'w o ,,tr Erf�m�e7 Seal Page 2 of 2 72-026 (Rev 8'867 Back tA a �/ GaeY 5. Mey, 5353 . Anchorage December 22, 1986 P.O. `BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907)264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Carey S. Meyer, P.E. Bess, Epps & Potts 2220 East 88th Avenue Anchorage, Alaska 99507 Subject: Lot 1 Block 6 Sand Lake Number 2 Subdivision Waiver request WR86-170 Dear Mr Meyer: Your waiver request dated December 15, 1986 for the above mentioned parcel has been approved. The standard separation distance of 100 feet from seepage pit to well and septic tank to well has been waived to 95 feet and 96 feet respectively. This waiver applies only to the existing seepage pit and septic tank, any future upgrade to this system will require another waiver approval from D.H.H.S. Sincerely, D - p n'V Daniel J. Roth Civil Engineer On -Site Services �n _ITY OF ANCHORAGE December 11, 1986 T. ^F HEALTH & INTAL PROTECTION Mr. Steve Morris DEG 15 1986 Municipality of Anchorage r Department of Health and �''` Environmental Protection 825 "L" Street Anchorage, AK 99501 Re: Waiver Request for Separation Distance Lot 11 Block 6, Sand Lake No. 2 =� Dear Mr. Morris: LOWThis letter is to request a waiver of ADEC/DHEP regulations for the separation distance to a septic tank and seepage pit for the private well located at the above-cited legal description. specifically, we are requesting a waiver for a separation distance of 96 feet to the on-site septic tank and 95 feet to the edge of the seepage pit. (These measurements were scaled from a surveyed as -built done on December 11, 1986. The DHEP inspection report from 1976 shows these distances to be 100+ feet from the well.) The well is located in front of the house, and the septic system is behind the house. The lot's contours would indicate that the seepage flaw will filtrate away from the well. The septic system performance during our adequacy test showed a water acceptance rate of 6.9 gpm. Further, the well log states that the well was drilled and cased to a depth of 256 and 257 feet, respectively. Lastly, the DHEP files for this lot contain a service contract for the septic system. From our investigation of this service agreement, we have concluded that the contract does not apply to this septic system. The present owners constructed the house and septic system in 1976. This date agrees with the DHEP inspection report. The present owners had purchased the property from the estate of the prior owner. The previous owner had planned to install a "treatment plant" system which would have required the service contract. However, the present owners elected to install a conventional seepage pit system. Therefore, an on-going service contract is not necessary. If you have any questions, please do not hes7�ta tcb qct me or Andy Potts at 349-6451. !it fl,4�� S, erely 15 w�EO q Up Gdfi fip a°° COe°6°Ono®c^a� AP °°E A pa0 ae.°efi ed Carey s.+I MeyE � � �® fJ ��) PE e o CryS.M r r� �� °®B 635 m9k/smh ENGINEERING, PLANNING, SURVEYING PROEESS,��� 2220 E. 88th Ave. /Anchorage, Alaska 995071 Telephone 91` 344-1352 "Providing a quality personalized service to those building Alaska's future" Loca tion: ' BESSE, EPPS & POTTS 2220 FAST 88 AVENUE ANLL;ORAGE# AK 99507 (907) 349451 WATER WELL TEST Date: 1z 11 8a Subdivision: /fe NO. ,Z Lot: / Block: 6 Client's Name: G/C O A/ Address: 8.20 .5'eAyi'e46/1.7 s ac3°°G a0a°a°ab na ° A n � eaaoa 10. Tester: JE t% 40 o Car �0 53 ate® ea Oe °Deas°c P� AROFESSIO -P 41Initial Reading on Meter: �j $ ! O ®®® n TIME CPM GALLONS GALL�yg' A vOLUME TOTAL VOLUME Of/ y0 ,' 40 19 130 s .3..y C? 915 S si G3Y a o s 7a 9 y os 770 S6V.16 s/ 8'3 s3 .7 NOTES: Prorinc-Hen Rate: 6.9 GPM 24 -Hour Capacity ??D6 callcn3 A 0 m 30 MUNICIPALM OF ANCHORAGE DEPT. OF HEALTH & � ENVIRONMENTAL PROTECTION V NI DET 151966 RECEIVED Ave . 1 IO Entry Doak F-- 4= _ S, u t O 5%and P'pe Sundatlon:-l..In&_ J I� 1 I9 a W Grove L Parkin j n SIn in-4la- -Fcr iIy. o d : Pad n 3oI Ih .� zs- A drd'w �F. Pmts Flo. 3514•S •• 1 SURVEYOR IS CERTIFICATION _ MUNICIPALM OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION DET 151966 RECEIVED Ave . Entry Doak F-- 4= _ S, u t O 5%and P'pe Sundatlon:-l..In&_ J I� 1 I9 a 2 SIn in-4la- -Fcr iIy. L 07- !DY -50!1 OClean 0 Septic rank Out Q 89655' w 135:00 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAT AND THE IMPROVEMENTS SITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. 04110 DATED THIS .L1— DAY OF['G. ,19=51. LEGEND O LOT CORNERS FOUNDATION ---_— DRAINAGE ARROWS NOTES- 1. IT SHALL BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VERIFY THAT BUILDING LOCATION SHOWN MEETS ALL SUBDIVISION COVENANTS AND ZONING ORDINANCES. P. IT 19 THE RESPONSIBILITY OF THE BUILDER TO VERIFY ALL ELEVATIONS WITH RESPECT TO ALL UTILITIES, Qtr pRA-MAGE • - 3. THIS PLAT REPRESENTS THE PARCEL Of PROPERTY DESCRIBED BELOW TAKEN FROM THE RECORDED PLAT DESCRIBING THAT PARCEL. INSTRUMENTS RECORDED PRIOR TO OR AFTER THE FILING OF THE RECORDED PLATARENOT SHOWN ON THIS PLAT. 4. THE INFORMATION ON THIS PLAT IS FOR THE USE Of LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS , THE PLAT IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCES. ...A.S B U I LT - LoT 1, BLOGK (o �A1.lD .LAKE 6 U 6 D Ne.2- BESSE, EPPS a POTTS 2220 E. 88th. AVE. 349-6492 ANCHORAGE, ALASKA 99507 349-6454 DRAWN BY, KML SCALE- 1",20I1 C -C DWG. NO. CHK. BY, ,4- DATE- 1?-/11/8(,FLO.BK.-