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Home My WebLink AboutSAND LAKE #2 BLK 6 LT 22Sam ACA. (� �a J(l'bll- 133-15 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191110 PID Number: 011-133-15 p' Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 9 Upgrade Name FRANK RAST ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 8230 WILCOX STREET *ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-230-4662 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot SAND LAKE #2; BLOCK 6, LOT 22 Fill added above original gr Ft. Gravel length Ft. Township Range Section - Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well *82'+ TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER TANK Capacity 1000 Gal. Surface Water 100'+ Material Number of compartments Lot Line *31+ NA HDPE 2 Foundation 10 1+LIFT STATION Manufacturer Capacity Remarks *WR#OSV191019 Gal' OLD TANK HAULED OFFSITE Alarm location Electrical installed by Installer PIPE MATERIAL House to tank Tank to drainfield GLW ENTERPRISES Drainfield CO/MT Inspector FRANK RAST, P.E. BENCH MARK (Assumed elevation) 100.00 ft Inspection dates: 1� 2n Location and description HOUSE TOP OF F D N 3rd 4m ON-SITE WATER AND WASTEWATER SECTION APPROVAL.,,vtk Conditional Approval: �¢� Mss■er�,� Date'` s f9 «ebp b[ ee on o:000e n+-0 V ■M� egpp eee oe � !%�, yrt� � � /l011�•� o YC�� Septic System A"�., �`'�`' n•'�� Approved Date 7lgl,�4.?Upp ,..d■o� � � e �. ROfi�S►1 ;;. Note: this approval does not include well permit requirements. (Rev u5/u2/1 a) PERMIT OSP191110 RECORD DRAWING PARCEL 011-1D NUMBER: 011-133-15 A STI 12.6 35.1 ST2 11.6 30.3 DBL1 13.3 24.7 DBI -2 LOT 1,BLOCK 6 MT 15.5 23.4 SUMP 35.4 13.6 w. s2ND BLVU I SAND LAKE�t2 /\ SAND LAKE #2 I (:" SAREA LOT 24,BLgCK 6EPTIC 1 -- ___ _Seo c0 LOT 1,BLOCK 6 I E EXISTING 3 BEDROOM B \ •':N HOUSE / / / C / \ \ 1 \ • /I 88, /SAND LAKE #2 2,BLOCK 6 SAND LAKE #2 LOT 23,BLOCK 6 / v\ //LOT I / LOT D20,BLOCK 6 1 / APPROXIMATE LOCATION OF EXISTING DRAINFIELD �o p xfi NEW MT DOUBLE CLEANOUTS s m F t-� �11'r ambom e�''Wil� OOo� o" .o'Oe PREPARED FOR: PHONE NUMBER: PAGE NUMBER: � °o '4 oo FRANK RAST- 907-230-4662 2 OF 3 PREPARED FOR: -Tof -'o LEGAL DESCRIPTION: DRAWN BY: -- SAND LAKE #2; BLOCK 6 LOT 22 TYPE OF WORK: DATE: z..),70 SEPTIC TANK RECORD DRAWINGS ``'z/ INEW 1000 GALLON HDPE SL&BGREER TANK o cn -- ___ _Seo c0 m LOT 6 E EXISTING 3 BEDROOM B \ •':N HOUSE GAR)kGF �: of : r \ 1 / C / \ \ 1 \ • 88, t-� �11'r ambom e�''Wil� OOo� o" .o'Oe PREPARED FOR: PHONE NUMBER: PAGE NUMBER: � °o '4 oo FRANK RAST- 907-230-4662 2 OF 3 PREPARED FOR: -Tof -'o LEGAL DESCRIPTION: DRAWN BY: -- SAND LAKE #2; BLOCK 6 LOT 22 TYPE OF WORK: DATE: z..),70 SEPTIC TANK RECORD DRAWINGS ``'z/ D4,BLOCK LOT 6 SAND LAKE #2 LOT 21,13LOCK 6\ \ C / \ \ 1 \ i 88, 100' WELL RADIUSSAN I / LOT D20,BLOCK 6 1 100' WELL RADIUS / SAND LAKE #2 LOT 5,BLOCK 6 100' WELL RADIUS I \ \ / \ N � SAND LAKE #2 SAND LAKE #2 \ LOT 6,BLOCK 6 LOT 19,13LOCK 6 SCALE: Y t-� �11'r ambom e�''Wil� OOo� o" .o'Oe PREPARED FOR: PHONE NUMBER: PAGE NUMBER: � °o '4 oo FRANK RAST- 907-230-4662 2 OF 3 PREPARED FOR: -Tof -'o LEGAL DESCRIPTION: DRAWN BY: -- SAND LAKE #2; BLOCK 6 LOT 22 TYPE OF WORK: DATE: z..),70 SEPTIC TANK RECORD DRAWINGS ``'z/ OSP 19110 Supplemental Report Location: 8230 Wilcox, Sand Lake #2, Blk 6, Lt 22 Contractor; GLW Enterprises Equipment; Bobcat 435 Fast Track Excavator, Bobcat T140 skid steer. 5/23/19 Contractor exposes existing tank. Outlet corroded off, pinhole leaks on primary shell at water level. Minor rust spalling on tank crown, compartment cover welds heavily corroded. 5/24/19 10:00 AM Tank pumped and removed, sludge evident in downstream pipe. New monitor placed to 9 - foot depth, 3 feet upstream and 1.2 feet north of old tank outlet. Sewer rock placed to pipe invert at old tank location. New tank installed approximately 9 feet upstream from old tank location on 12 -inch depth pea gravel. Tank inlet connected with Fernco and 12 -inch spool to existing pipe. Romac SS Reoair clamp used at existing pipe connection. Tank backfilled to springline with pea gravel. 5/28/19 A 5 -foot spool of perforated pipe connected to existing leachfield approximately 38 feet from house foundation with Romac SS repair clamp. Double clean-out connected to perforated pipe, 4.5 foot spool connected to new tank outlet with Fernco coupling. All new pipe is 4 -inch Cresline PVC ASTM D3034 SDR 35 sewer pipe. Sewer rock placed to 6 -inches above perforated pipe. Pea gravel placed above pipe and tank from double clean-out to existing connection 19.6 feet from house foundation. Fabric placed over sewer rock and pea gravel. Remaing excavation backfilled to grade with on-site excavation. 5/31/19 10:00 AM Isaac's Pumping vacuums leach line, flushes line with hydrostatic pressure and back flushes and collects residue. k�.�� ' �.. .. /§. + , ®- Typar Over Classified Backfill /� � ^ �41 . � ° . . = t LOT 23 LOT 2 N900 00'00"W 135.00' 5.5' 30' X X X XCO X X X 58' CO MT �� 29.2' 40.2' 0 DOUBLE CO SHED o x TANK CO 2 0 0 10.3' TANK CO 1 L w W LU 28.3' � LOT 22 N EXISTING HOUSE N LOT 3 o x o 0 N DETACHED N. o C:) N GARAGE N. 40.3' o O ................ 0 9.4'... oo v C:) ............................4% z =10.4' 28.3' o,. ....................gyri.............. 000000p� 6.9' 6.9' Op _0 0 FA ��30 0 N900 00'00"E 135.00' 49TH V LOT4 .............�..^^ ..... O�% LOT 21 STEVEN CALLAGHAN.- S-12034 ALLAGHAN.S-12034 Qlofessiono\ �oo ORDERED BY: FRANK RAST LEGAL DESCRIPTION: LOT 22, BLOCK 6, SAND LAKE SUBDIVISION NO.2 DRAWN DATE: 7/1/2020 DRAWN BY: AP CHECKED BY: SC SCALE: 1 " = 20' WORK ORDER: 20025 PLAT: P-176 GRID: SW2224 FB/PG:817/38 REF: 031_439A NOTE: 250 H Street Anchorage, Alaska 99501 JCG Survey Department _.�S.JC.h Inc Phone 562-5291 Mainline SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE Phone 243-8985 AECC 668 ORDERED BY: FRANK RAST LEGAL DESCRIPTION: LOT 22, BLOCK 6, SAND LAKE SUBDIVISION NO.2 DRAWN DATE: 7/1/2020 DRAWN BY: AP CHECKED BY: SC SCALE: 1 " = 20' WORK ORDER: 20025 PLAT: P-176 GRID: SW2224 FB/PG:817/38 REF: 031_439A NOTE: THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. ADDRESS: 8230 WILCOX ST. PARCEL* 011-133-15-000 AS -BUILT SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. LEGEND: SEPTIC Asphalt STANDPIPE CO —QEXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCE O Concrete WATER WELL OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO Overhang NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES —X—X— SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTY EE��,FENCE Woed Deck LINES, OR FOR PLOT -PLAN PURPOSES. HL,„ MUNICIPALITY OF ANCHORAGE Zll i 111 On-Site Water&Wastewater Program �0\ -. 'S PO Box 196650 4700 Elmore Road ;•fi Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax (907)343-7997 http://www.muni.org/onsite .; I) partntcnt <HONx0- On-Site Wastewater Disposal System Permit Permit Number: OSP191110 Effective Date: 4/24/2019 Work Type: SepticTank Upgrade Expiration Date: 4/23/2020 Tax Code Number: 01113315000 Site Legal Address: SAND LAKE #2 BLK 6 LT 22 G:2224 Site Mailing Address: 8230 WILCOX ST, Anchorage Owner: RAST FRANK Lot Size in Sq Ft: 6750 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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: �- Date: 'S I1 Issued By: /C(.t/ .4 : // Date: yilrf »lent S Municipality of Anchorage rfrTih:�:� \ Department P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Department On-Site Water and Wastewater Section **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV191019 COSA#: Permit#: OSP191110 PID#: 011-133-15 Legal Description: Sand Lake#2 Block 6 Lot 22 Engineer: Garness Engineering Group Applicant: Frank Rast Your request for a waiver of the required 10 feet horizontal separation from the septic tank to the property line has been approved. The approved separation distance is 3.0 feet. Your request to amend the existing 92 ft waiver between the well on Lot 22 to the septic tank on Lot 22 has been approved. The approved separation distance is 82.0 feet for the proposed septic tank. In addition, the existing 88 ft waiver between the well on Lot 21 to the septic tank on Lot 22 is renewed for the proposed septic tank. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: l 2 7 q Approved by: lailleeN 6/1/Z4r(1 Name of Reviewer **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-79 Development Services Fax: 907- 3437799 9 Tp On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application APR 1 72019 For A Single Family Dwelling Parcel I.D. 011-133-15 4,� sl Property owner(s) FRANK RAST Day phone 230-4662 Mailing address 8253 SEACLIFF STREET*ANCHORAGE,AK 99502 Site address 8230 WILCOX STREET*ANCHORAGE,AK 99502 Legal description (Sub'd, Block& Lot) SAND LAKE#2: BLOCK 6. LOT 22 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (®all that apply) Initial ❑ Single Family (SF) Absorption Field ❑ (w/wo ADU) Septic Tank ® Upgrade IZ Duplex (D) [ 1 Renewal ❑ Holding Tank I I Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well al Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: WELL ON LOT 21 &22 TO PROPOSED SEPTIC TANK&LOT LINE WAIVER Distance: 88, 82, &3 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: -6-- Waiver Fees: N 22 5/ Date of Payment: W 1!709 Date of Payment: -1/ ,2 `{ Receipt Number: /� ab a�.io Receipt Number: 011 3 a G Permit No. 6,SP1 q i 1 VO Waiver No. O S\1\1 01 9 (Rev.01/11) i Ale Al GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING April 9, 2019 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Sand Lake #2; Block 6, Lot 22 To whom it may concern: The existing 3-bedroom house is served by onsite wastewater and a private well. We have been contacted by the owner (Frank Rast) who stated that the septic tank was in a state of failure and needed to be upgraded. We are proposing to decommission the old 1,000-gallon steel septic tank and install a new 1,000-gallon poly-coated steel or concrete septic tank (contractor/owner decision). The proposed tank will encroach on the same two wells that the existing tank encroaches on. The encroachments, the requested waived distance, and justifications are noted below. WAIVERS • WELL ON LOT 22 TO PROPOSED SEPTIC TANK ON LOT 22 — We are requesting an eighty-two (82) foot waiver request from the proposed septic tank on the subject lot to the well on the subject lot. o There is an existing encroachment between the well and the existing steel tank (92 feet) o We are proposing either a concrete or poly-coated tank o The existing tank is assumed to be compromised and potentially leaching • WELL ON LOT 21 TO PROPOSED SEPTIC TANK ON LOT 22 — We are requesting an eighty-eight (88) foot waiver request from the proposed septic tank on the subject lot to the well on the neighboring lot. o There is an existing encroachment between the well and the existing steel tank (89 feet) o We are proposing either a concrete or poly-coated tank o The existing tank is assumed to be compromised and potentially leaching • PROPOSED SEPTIC TANK TO NORTH PROPERTY LINE— We are requesting 3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com Page 2 of 2 a three (3) foot waiver request from the proposed septic tank on the subject lot to the north property line o There is an existing encroachment between the existing steel tank and north property line (approximately three (3) feet. c The waiver to the lot line will allow for the ten (10) separation to the garage foundation. o The existing tank is assumed to be compromised and potentially leaching We are unaware of any adverse impacts this installation or waivers would have on adjacent wells or septic systems. If you have any questions, please contact us at 337- 6179. Thank you for your assistance. Sincerely, --Jeffrey A . a 'ess, P.: ., M.S. Presiyie, 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website:www.garnessengineering.com W.82ND B . _ 100' kik_ .- �r�- SANE VW: �1 vel '•°1•11�'� pTIC -ANrMIN AND LA •2 SAN LAKED #2 LOT,BLOC D LAKE#2 •I - F OT ► •T 1,BLOC LOT?4,BLOCK 7 • 1,BLOCK• I,�r1 .� 1. �, 2,BLOCK: • - N. KE#2 SAND LA E#2S or.: TER SERVE` WELL R SERVED BY 1 2,BLOCK 7 LOT 23,6 OCK �. _, -IlSAND LA 1a ' Ir�; ' rr LOT 23,B3111 • RIMDIE V: • :�/ OT 1. MI% hui./r •BLO SAN I • FE#2 _.c �.�L �� tv'ca /� LOT •,:LOCK? � . /iJii ` �,. 100'WELL RADIUS •ND LAKE#2 ,� • SAND - • :LOCK 5 :- • • 2 ,1 ' , • 4,BLOC. 100 i, ; DIUS• a •�r100' • ..• . D LAKE#2 • 00'WELL RA12,01111r.• �1 Aga RADIU I L 2 • . OCK 5 r r { LOC. 100'WEL'+7Q � SAND LAKE#2 I `��iiY►►'" ll • � LOT S,BLOCK 7 ❑ , IIFAIMII!!_ kaiif'U 0T6,BLOCK7ca IIIAND LAKE#2 ...I' -• _WWI L!T 18A,BLOCK 5 I � �� s- D LAIC. �D : 1�;' • . MOW 2 AND LAKE#2 F L•: 7 BLO • ',BLOCK 6 OT 7.BLOC•7 L•T 18,BLOCK 7 Elww • c, r co SAND LAKE#2 I D LAKE#2 NI. SAND Pl. SAND LAKEN 'I SAND .•KE#2 LOT 17,BLOCK 5 > :BLOCK 6 • . OCK 6 4.3.T 8,BLOCK 7 LOT 17,:..•CK 7 w AND LAKE#2 SAND LAKE#2 1 OT 16,BLOCK 5 LOT 9,BLOCK 6 SAND BLO #2- AND LAKE#2 p %IC A LOT 9,BLOCK 7 OT 16,BLOCK 7 Z II SAN• -is SAND • E#2 SE• IC •AND LAKE#2 SAND 2 le— .BL• 6 LOT 15,;:LOCK6 AR� • 10,BLOC 7 LOT 1S.BLOCK7S ALE 0 -i . I 1 - 100 SAND LAKE#2 SAND LAKE#2 SAND LAKE#2 17 cc LOT 14,BLOCK 5 LO 1D LAKE#Z, LOT 1 , #2 LOT 11,BLOCK 6 fo LOT 14,6_OCK 6 LO 11,BLOCI��7 LOT 14, LOCK 7 - .'��\\\� •nr 1I. S IN __ ._l_ ___ GARNESSENGINEERING9 ..,�. GROUP, Ltd • . ENGINEERING•SALES•CONSULTING ` •0 3701 E.TUDOR ROAD.SUITE 101-ANCHORAGE.AX 99507•PHONE(907)337-6179-FAX(907)338-32.6-NERSTE:www. aenyn•emycon PREPARED FOR: 'PHONE NUMBER: PAGE NUMBER: 0A141,7,".._ .1,, : 1'. Games- c FRANK RAST 907-230-4662 1 OF 2 j �, .• E - . •- PROJECT/LEGAL DESCRIPTION: DRAWN BY: .♦ • ••••.,, u] L •J09 • SAND LAKE#2; BLOCK 6, LOT 22 PNB 1. ♦ p•,�,•.!1.•• P,\, ..w TYPE OF WORK: DATE: LICENSE 4 ESS •• SEPTIC TANK DESIGN 4/9/19 #AECC884 , �� • \.. GEG,Ltd.HAS AN 8 PAGE SPECIFICATION LETTER NOTE:CONTRACTOR MUST HAVE ALL 100'WELL THAT PERTAINS TO THIS DESIGN.BY PROCEEDING RADII WHICH ENCOMPASSES THE SUBJECT LOT, W.82ND BLVD FORWARD WITH THIS INSTALLATION,THE ALONG WITH ALL WAIVED DISTANCES,AND THE ENGINEER,WELL DRILLER,CONTRACTOR AND NORTH PROPERTY LINE FLAGGED BY A PROPERTY OWNER AGREE THAT THEY HAVE PROFESSIONAL LAND SURVEYOR PRIOR TO READ THESE SPECIFICATIONS AND AGREE TO CONSTRUCTION AND ENGINEERS LAYOUT. ACCEPT THE TERMS AND CONDITIONS OUTLINED.,�/ _ SAND LAK #2 lippw• SEPTIC LOT 24,6E CK 6 SAND LAKE#2 , LOT 1,BLOCK 6 R E� ^ ____ 1 AND LAKE#2 S'ND LA #2 •� LOT 2,BLOCK 6 L a T 23,6 OCK 6 XISTING .000 GALLON STEEL ,�`'� 4:),s; 90/G SEP IC TANK TO BE cc� s DECOM ISSIONED PER UPC "TOI Tr iiik •ROPOSED 1000 GALLON POLY-COATED STEEL OR CONCRETE 0 SEPTIC TANK x S u• — ��ta` v �1 TING EXISTING 3 m • I xmH DRAINFIELD `1 ` t BEDROOM *•' • HOUSE AKE#2 , LOT:,BLOCK 6 GA-f- • :'t '_:, j ` SAND LAKE#2 LOT 4,BLOCK 6 SAND LAKE#2 LOT 21,BLOCK 6 ill hilbis/Pw,jV ER REOU. T iti 100'WELL RADIUS 11111 • ll illbl SAND LAKE#2 , 1 LOT 20.BLOCK 6 100'WELL RADIUS '1 } - O r SAND LAKE#2 l FAA 1 LOT 5,BLOCK 6 100'WELL RADIUS 0 (.r,\I (A. jaw— SAND LAKE#2 SAND LAKE#2T .X . _._ ".40' LOT 6.BLOCK 6 LOT 19,BLOCK 6 / slut •4•�� • . * GARNESS ENGINEERING GROUP, Ltd 1 *-�• '9/'•: '.-* ----- -_-.-.----- ENGINEERING SALES CONSULTING — -----_-- 0 / 0 • 3701 E.TUDOR ROAD,SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179•FAX(907)338-3246'VIEBSfTE www.games eern►g co . PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 t4A S e -` •. Garne•s e • FRANK RAST 907-230-4665 2 OF 2 • 0 's CE 79 '_� PROJECT/LEGAL DESCRIPTION: DRAWN BY: .(� y .......1 b I �•.(` l SAND LAKE#2; BLOCK 6, LOT 22 PNB /.r�••p''••••V,1 (`' P,, • TYPE OF WORK: DATE: LICENSE 4 It,�„`\\-�•• SEPTIC TANK UPGRADE DESIGN 4/9/19 #AECC884 J 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 NAME / PHONE 9FEW ❑ UPGRADE i A/- Al, �� Q L. MAILING ADDRESS LEGAL DESCRIPTION LOCATION l v NO. OF BEDROOMS 3 Well Absorption area Dwelling C r PERMIT NO. i%96 Z- DISTANCE TO: �, r' f G�.3 Uy H z Manufacturer Mate rigl No. of compartments Lu to ~ Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. O Z DISTANCE TO: JO Q Manufacturer Material Liquid capacity in gallons 2 F p DISTANCE T0: well Foundation Nearest lot line r PERMIT NO. w= 001 LuLL Z No. of lines Length of each line Total length of lines Trench width ,L Distance between lines _ Z �� .22 3 inchds I' F.. Top of tile to finish gradeID, Material beneath the /- i¢chcc Total effective absor on area Q O Length Width Depth PERMIT NO. UA Qa F Type of crib Crib diameter Crib depth Total effective absorption area ui LU Well Building foundation Nearest lot line (A DISTANCE TO: CI s .y-A 7 Depth Drifter Distance to lot line PERMIT NO. J ', /t' � J w �i Building foundation Sewer line Septic tank Absorption area(s) 3: DISTANCE TO: OTHER PIPE MATERIALS A �T�/ t b S0IL-TEST RATI NG �y D S INSTALLER O' t REMARKS 0 C APPROV D DATE LEGAL Ltl W.V 72-013 (Reff78) - V YI W� O I ro Y I ` TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH -.- I 'i NUMBER OF BB}ROOMS = ] SOIL RHTING <SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL H8SORPTION SYSTEM IS� ��-r "� :lLR�F- ��--- :_2 1:3 F�F:� %z T= I EE; THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELC! THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DE�TH OF G�HYEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET) z. EE I g- "T_��_5 PERMIT APPLICANT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. _r L4 Co ME�T �E�L7� HN� ��YIRONME��L JTECTIG� ANY SYSTEM WITHOUT FINAL INSPECTION AND STREET. HNClmORHSE, DEPARTMENT WILL V'. /�o-/�^�/ SUBJECT TO PROSECUTION. 264�472�y � / ' . ��_�~ �� EA4�� co ?-I � �� F��1�_-� P1-IRMIT ~ NO. ( 810862 ) APPLICANT DANNY CHROLHND PO BX 10-1682 HNCH LOCATION WILCOX LESHL L'[22 BLK6 SHMDL8KE S/D #2 LOT SIZE 6800 SQUARE FEET ` TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH -.- I 'i NUMBER OF BB}ROOMS = ] SOIL RHTING <SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL H8SORPTION SYSTEM IS� ��-r "� :lLR�F- ��--- :_2 1:3 F�F:� %z T= I EE; THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELC! THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DE�TH OF G�HYEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET) z. EE I g- "T_��_5 PERMIT APPLICANT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. _r L4 Co :2 > I r -A —=� F:" E=-: A::� -r I �D F=q�X� ��M�� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MI��IMOM DISTHNCE BETWEEM 8 WELL HND HNY ON�SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING ;PON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIYHTE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPHRTMENT WITHI�-4 -Cl DHYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPEC IFICHTIDNS AND CONSTRUCTION DIAGRAMS ARE � AVAILABLE TO INSURE PROPER INSTALLATION. ��Rnr--1 I -r EE.4:--�F:�' 3: ��1::- E7 r-1 E3 F7 2.1 ^ -I *F4 -9 I CERTIFY THAT � 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET � FORTH BY THE MUNICIPALITY OF ANCHORAGE. � 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. Seet,� ' ~ � HPF�-ICHNDANNY CAROLAND 4ISSUED BY _____--DHTE__��__��L_y-j_ �� ^r~ go,/ 70 V4.0 0^�� [~��d��v`^~ A MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST SOILS LOG ❑ PERCOLATION TEST �� V PERFORMED FOR:1//7& /i�L%1l iJ %lSl%.i/+o,�5A4T.��- DATE PERFORMED:4IJe�,t '4'a1 19 R% LEGAL DESCRIPTION: /-d977 /P J2A. DEPTH (FEET) 1 X 2- 3 3 4 �✓ 7- 8- 9 s 9 /<<' �i 10 47 •s' � k 12 • �r 13 4 4, 14 15 of 16 17 18 Vr Oo �p 19 r ¢a PV42LAser- SLOPE - qlr WAS GROUND WATER ENCOUNTERED? C44'=AA4 .5A/V YIF YES, AT WHAT 6 WDEPTH? VV S Ej Reading Date Gross Time Net Depth to Net Time - Water Drop lot .� OF 14 %1 •• 1 �. • G,•,• 6411, . ,...... j - : I i i —r - i g9Fpp •••... ••�P��AV II i f i I VV S Ej Reading Date Gross Time Net Depth to Net Time - Water Drop .� OF 14 %1 •• �. • G,•,• 6411, . ,...... j d� �%' Earl R. 8 rnard a g9Fpp •••... ••�P��AV 20-.eg TrV A,, PERCOLATION RATE (minutes/ince r� 'rr / `x/ TEST RUN BETWEEN FT AND FT COMMENTS �Y.%f9 r C .% "AH i Z2 ZF,4�P if 25,C4 A4 -511211– IJL%%G a)A%K;' PERFORMED BY: 0_4A5L. ZZ CERTIFIED 72-008 (7/76) I DAT {6 y�vU .4VC+//��E:� //' I rOP OF FOUNDATION WALL ELEVATION =— ELEVATIONS BASED ON PREPARED FOR: P. 6AI91PLAND r 30 30 SCALE C-50, N 2 1 U) 3 X O U J 4Cj QS 5 ,9.5 7 L t 6 t n 0 ® p y o p 0 $ E b W E I. l ❑ p R o r o c E- n S r --p T 1 G IT SHALL BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VERIFY THAT BUILDING LOCATION SHOWN DATUM. MEETS ALL SUBDIVISION COVENANTS AND LOCAL ZON— ING CODES AND ORDINANCES. PLANIoIl• LOTS 20,21,22, BLOCK 6 SAND LAKE SUED. N0. 2 w u.a 18 he�iag D2224 1 Nj- 2 1 IRS' . FAt��Xj `•�� F. LEE KARABELRIKOFF,'v Na 3143-S� i ••.......••'oS�,,�' F� George M. Sullivan Mayor ANCI��'UkQE WAj ER & SEWER (,__.,1L,ITIE'-1 August 17, 1981 3000 Arctic Boulevard Anchorage, Alaska 99503 (907) 277-7622 Mr. Danny Caroland Caroland Investments P. O. Box 10-1682 Anchorage, Alaska 99511 Dear Mr. Caroland: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL I'-,OTECTION AUG 1 8 1981 RECEIVED Sewer service to the 80th Avenue/Wilcox Street area handled by the C-3 North Trunk that is tentatively construction in 1983. At that time lateral service extended to the 82nd Avenue/Wilcox area via private or a Lateral Improvement District formation. Sincerely, DONALD C. +EEER Asst. Civil Engineer Anchorage Water & Sewer Utilities DL:deb Owned by the Municipality of Anchorage will be scheduled for may be development 'TYPE OF OIL ABSORPTION SY TEM .T. E• : TRENCH MA;:<;Ttill-IM NUMBER OF' BECiF.'l'iC€MS - _ SOIL REIT'Iparte (SO FT/ R)=: '_:�� THE REQUIRED SIZE CAF' THE SOIL Hr--; ORPTIIII'l _;,a2 " T •: / THE LENGTH DIC'tE.ISIONI IS THE LENGTH (IN FEET) OF 'THF" TRENCH OR DRIAINIFIEL.C:'. THE DEPTH OF' H TRENCH OR PIT IS THE C:'T'-;""- ,CE E. ' T WEE.pa THE SURFACE OF' THE GRCrI_NC.", AND THE BOTTOM OF THE E'HVATIt, N '.. IN FEE THERE IS r,10 SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH is THE MINIMUM DEPTH OF €_ '-v'E{_ _..TI.•.:ENI THE OUTFALL F'IF'E FIND THE BOTTOM OF' THE: EXCAVATION ':: I I FEE'l _ _ E �: JF"=' : N;"e F= 'T- �d ate: -3 �""1\ 1 s-:-_ S �- - - _ �9 f R C-1 4D; I L_ Awa rJ'- -; F'ERM,IT APPLICANT HAS THE: RE'=S ?'_; B+LTTY TO i ..F1 -!..t'1 ''HIS DEF'HRTIlEpaT DURI'PIG rHE I p,l'�TFILt_F1"(' I €:!pa INSPECTIONS OFI Ira T I IELL AC':TH€' .p.!' TC THIN PROPERTY AND THE NUMBER €,€F F:E'= T[;rCt,!r E:' ('HFkT' THE •.IEL_ (2i_L E,� :;,,' EIt!::F`:FTLLIP?(i OF Flp,l'r' E;`r' •!E:!'1 ! T"CH €!IT F'Tp? t?'•F'Ei TTi=rp•? Np,D APPROVAL BY THIS C:'EFyF'Ch1Et,!T" WILL OF. SUBJECT 0 F:C€ :E C:-TT_p�. MINIMUM {)I_':-;THp••CE BETWEEN H !.•?EL7' fIp I'?' ON—SITE SEWAGE C:'I •POSAL `SYSTEM IS :100 FEET F1:R A PRIVATE WE:L.L IrrR ;1'0 fC! �0 FEET FROM FI F't._tE:LIC: {.TEL I_. C:'EF'Epa{rIr•?!a I_IF'i:€pa THE 'i'r'F'E !::iF PUBLIC I! F+!ELL.. MINIMUM DISTANCE FROM H F'RIVH E.L€_ T o A PRIVATE E SE14ER LINE I 25 FEET At -41) TO FI C rMMUNIT? SEWER LINE: T_=' '7 FEI"C. !•'.TELL LOGS ARE REQUIRED AND I_i {' BE RETURNED TO THE DEF'HRTMEta'T [,?ITFiIt, T D' ?A. it THE WELL COMF'LETIOp,i I. OTHER REQUIREMENTS I'1FI'i' APPLY.PE'CIFICAT'ICip•S AND CONSTRUCTION C'IA13F Ar"IS AVAILABLE TO € Ip• SURE PROPER Ip,1ST'HLt_ATI061. F-- , F : &-" 2c.l T CERTIFY THAT 1: i FIM FAMILIAR WITH THE REQUIREMENTS FOR Oh! -e; I TEEWER' � FIND IWELLS AS SET FORTH BY THE NUt11 I RAL I T'' OF' HI'•?C HORH!3E. _.: I' WILL INSTALL THE SYSTEM 'TEM I'r'a ACCORDANCE I.••IITH THE !_ODE7 . I I ip, DERE• T Hp•?E:' THAT THE ON -.SITE '-EWER SYSTEM MA'r` REI]!I-TIRE ENLARGE MEN'C IF I'L.I RESIDENCE I'_• REMODELED TO INCLUDE MORE: THAN E:EDROOM' APPLICANT r.HROL_Ar,ID INV I ,-•— r c _ dam. {?EF AR"I'"MEp,!'1' HEALTH Hp,TL:' EP -.I .' I F,"tOi`•?MENTAL.. DTEC:T I ON "= ='i'RE_ET, Cap,It::F!OT=:FU:aE: !-IF':. 264--.4720 t-4 L.__ F -R 1r" -R s,_,_5 P-4 •--- °_ ' 3: 7, E--"• ° a &= !1•""9� �m ° 9--_° ff,z. F.-:° I!'=l 1. _T... rERMIT N.O. 81081'9 .' HF'F'L.ICANT !_ ARi �L.Hp, D Ira',;. BOX 10:1682 ANC:H LOCATION 1-11 LCOX LEGAL_ L 22 B 6 '.Ap•?C:' LAKE S.. -CD # 2 LOT SIZE 7000 :_•rtl_tARE FEET 'TYPE OF OIL ABSORPTION SY TEM .T. E• : TRENCH MA;:<;Ttill-IM NUMBER OF' BECiF.'l'iC€MS - _ SOIL REIT'Iparte (SO FT/ R)=: '_:�� THE REQUIRED SIZE CAF' THE SOIL Hr--; ORPTIIII'l _;,a2 " T •: / THE LENGTH DIC'tE.ISIONI IS THE LENGTH (IN FEET) OF 'THF" TRENCH OR DRIAINIFIEL.C:'. THE DEPTH OF' H TRENCH OR PIT IS THE C:'T'-;""- ,CE E. ' T WEE.pa THE SURFACE OF' THE GRCrI_NC.", AND THE BOTTOM OF THE E'HVATIt, N '.. IN FEE THERE IS r,10 SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH is THE MINIMUM DEPTH OF €_ '-v'E{_ _..TI.•.:ENI THE OUTFALL F'IF'E FIND THE BOTTOM OF' THE: EXCAVATION ':: I I FEE'l _ _ E �: JF"=' : N;"e F= 'T- �d ate: -3 �""1\ 1 s-:-_ S �- - - _ �9 f R C-1 4D; I L_ Awa rJ'- -; F'ERM,IT APPLICANT HAS THE: RE'=S ?'_; B+LTTY TO i ..F1 -!..t'1 ''HIS DEF'HRTIlEpaT DURI'PIG rHE I p,l'�TFILt_F1"(' I €:!pa INSPECTIONS OFI Ira T I IELL AC':TH€' .p.!' TC THIN PROPERTY AND THE NUMBER €,€F F:E'= T[;rCt,!r E:' ('HFkT' THE •.IEL_ (2i_L E,� :;,,' EIt!::F`:FTLLIP?(i OF Flp,l'r' E;`r' •!E:!'1 ! T"CH €!IT F'Tp? t?'•F'Ei TTi=rp•? Np,D APPROVAL BY THIS C:'EFyF'Ch1Et,!T" WILL OF. SUBJECT 0 F:C€ :E C:-TT_p�. MINIMUM {)I_':-;THp••CE BETWEEN H !.•?EL7' fIp I'?' ON—SITE SEWAGE C:'I •POSAL `SYSTEM IS :100 FEET F1:R A PRIVATE WE:L.L IrrR ;1'0 fC! �0 FEET FROM FI F't._tE:LIC: {.TEL I_. C:'EF'Epa{rIr•?!a I_IF'i:€pa THE 'i'r'F'E !::iF PUBLIC I! F+!ELL.. MINIMUM DISTANCE FROM H F'RIVH E.L€_ T o A PRIVATE E SE14ER LINE I 25 FEET At -41) TO FI C rMMUNIT? SEWER LINE: T_=' '7 FEI"C. !•'.TELL LOGS ARE REQUIRED AND I_i {' BE RETURNED TO THE DEF'HRTMEta'T [,?ITFiIt, T D' ?A. it THE WELL COMF'LETIOp,i I. OTHER REQUIREMENTS I'1FI'i' APPLY.PE'CIFICAT'ICip•S AND CONSTRUCTION C'IA13F Ar"IS AVAILABLE TO € Ip• SURE PROPER Ip,1ST'HLt_ATI061. F-- , F : &-" 2c.l T CERTIFY THAT 1: i FIM FAMILIAR WITH THE REQUIREMENTS FOR Oh! -e; I TEEWER' � FIND IWELLS AS SET FORTH BY THE NUt11 I RAL I T'' OF' HI'•?C HORH!3E. _.: I' WILL INSTALL THE SYSTEM 'TEM I'r'a ACCORDANCE I.••IITH THE !_ODE7 . I I ip, DERE• T Hp•?E:' THAT THE ON -.SITE '-EWER SYSTEM MA'r` REI]!I-TIRE ENLARGE MEN'C IF I'L.I RESIDENCE I'_• REMODELED TO INCLUDE MORE: THAN E:EDROOM' APPLICANT r.HROL_Ar,ID INV I ,-•— r c _ dam. i� i; W.W.D. Water Well Drilling Phone 349-3809 Anchorage, AK. Well Owner Qom' Well Locatio Size Casing 6 " Static Water Level Date of Completion i3y ;2-,z3-5/ feet Date Phone .off 5 3C Depth of Hole� Cased to 5� feet Q Well Test (� Gal per Minute for _ 1 ,3,11 Hours ` WELLLOG AUTHORIZATION TO DRILL I hereby authorize W.W.D. Drilling to proceed with the above work. Payment shall be made in the following manner: Rig up Minimum (50% of anticipated depth) feet. @ Balance due upon completion. per foot In the event it is necessary to institute legal proceedings to collect any amounts due on this contract, I agree to pay an additional sum of Ten percent (10%) of the original contract price as attorney's fees, plus costs, for legal proceedings. Name Date � Address Well Owner 0.11Iuf��yc� Well Location/ ft;11,,/,/,-&-4��- Size Casing Static Water Level Date of Completion W.W.D. Water Well Drilling Phone 349-3809 Anchorage, AK. Date __Zr y/ Phone 3�15 -3% �' Depth of Hole Cl Cased to feet Well Test /Is — n WELL LOG . n ij ^i�is feet Gal per Minute for Hours AUTHORIZATION TO DRILL I hereby authorize W.W.D. Drilling to proceed with the above work. Payment shall be made in the following manner: Rig up Minimum (50% of anticipated depth) feet. @ Balance due upon completion. per foot In the event it is necessary to institute legal proceedings to collect any amounts due on this contract, I agree to pay an additional sum of Ten percent (10%) of the original contract price as attorneys fees, plus costs, for legal proceedings. Name Date Address Municipality of Anchorage O Development SeNices Department ° •°iYK a-'.�..• `'�-` bit Building Safety Division. On -Site Water and Wastewater Program ; t 4700 South Bragaw St. •," " 1 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A 51NGLE F=AMILY DWELLING - Parcel I.D. PV -133- is - HAA (�- _� .a ,s- -Expiration Date:`-=:/. _ p 1. GENERAL INFORMATION Complete legal description Lot 22 • Block 6 • Sandlake Subdivision 02 Location (site address or directions) •• • 8230 Wilcox St. Anchorage, AK 99502 Current Property owner(s) Gary Stevens Da • y phone 349-9993 Mailing address same Lending agency Mailing address Day phone Real Estate Agent Susan Bielman /'Dynamic Day phone Mailing -Address Unless otherwise requested, HAA WN be held by DSD for pickup.. 2. NUMBER OF BEDROOMS: 3 3 3- TYPE OF WATER SUPPLY: ' Individual Well Individual Water Storage Community Class Well Public Water System The Municipality of Anchorage Development Services bepartment (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water 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 relssuEd 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. TYPE OF WASTEWATER DISPOSAL: Individual On-site XX ❑ Individual Hoiding tank E] ❑ Community On-site El ❑ Public Sewer 0 The Municipality of Anchorage Development Services bepartment (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water 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 relssuEd 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. T. 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 ori procedures outlined in the Health Authority Approval Giiidelines for this application, shows that the on- Y. •`� •, p:, site water supply and/or wastewater•dis osal s stem,is are) safe,-.. citonai and adequate for the number of `•. ':` ;',;tz' 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 andlor wastewater disposal system is(are) in compliance with alj appriiai6ie Municipal and State coded ordinances: and regulations in effect at the time of installation: Name of 'f -Firm _..s_ &' S Engneer1TiE-_ ,; '.�+, V_1. �! r_�.. ra P171ii1F S_644=2979 _ : Sit'';'`rLb�i•aQle••tt'iver',,'.-AK 9957.7 _ Address 17034 11Eagle'Rive / Robert' C:'-:�owari Date63 Engineer's Printed Name .,}. "': •. ,u•. i'.F: N •!1::5:f [`. ,,•. r. ••! 'Vt t••'"'-!.'r`,Y y1 ...A' ,..i!.51d •. .�. .;..��-. •r r7r is r'.5.�/�+r\ Jy��, �.\ .. ',•',?...a': 1: :, l•f: ;i.^ra'_'.,.,. f''I✓iL Itdt� r.' �. ., . ... ;.; .i . .,' .t:.?.: yt; :. .•:i ',: .. r,(.l :�.•'iC � ,�' ruae«na:.rns•1� .. . :41'n•i• ;1:.',r �j ... i,'' •�::: ...w: •t i!��;�f.ltitC ♦•»• ♦' .J rk: t' "•�J a�/! • • ti\ 1 +I`, •!-•,'t.•. rr•i'• :a \,•�~ �,' M• I• •: i-v�..y, ••t•.••••,•1••aJY� '�' :+".;•: AODERTCGOWAN.+.�N'/10 5. DSD SIGNATURE ,: ;_:.;. ..,. x:8801.'-... 't ••Approvedfor 3 bedrooms.'' :; , / :•;,�L w. Vic;,..:. „ .�. '.•h,: •.M1; }•f•Y ••,t:�.t..'l�le'.,•; •,i '.,��, ri1.i•��j \i• „'.a•'. Disapproved. Conditional approval for. :' bedrooms,Vth the^following :.,.' i. ..,r,. d'•_•.it �•� Lu'' +t'!::'.: ': ilk;:'� .. .'•. .:,. . r:• . )•'}c h•C:1: �.'41�an T;11 .1 fi.•k.:vn.s,'•i. ,t;�ia ....-H r :i; :`f •.. :' ATE R AN Additional Comments ,. GRAM Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: V Original Certificate Date: % " Cl — �- 3 (Rev. 01102) . . ........ . ... j Municipality of Anchorage , Development Services Department Building Safety Division . L-4 ' On -Site Water & Wastewater Program wi s . 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: L u 7- a s GL -0 '-K 5-4_;'" AZ'.c E- Z Parcel ID: O /! — A. WELL DATA Well typePa V4 r f It A. B, or C provide PWSID # Well Log (Y/N) Date completed I;L1,X31k / Sanitary seal a1N YQ J Wires properly protected ®/N) YE 1 Total depth) y g ft. Cased toa ` Y ft. Casing height (above ground) ),X 4 in. FROM WELL LOG Date of test I X /a 5/ S Static water level 1 3 ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0. 1 mg.A. Arsenic: " mg A. Date of sample: (SIX V.;3 B. SEPTIC/HOLDING TANK DATA Tank Type/Material St P7, L / 9 i f: s;. L Tank size /o ° 0 gal. Number of Compartments Foundation cleanout ON) YCS Depression over tank (YAQ N Date of pumping g /X �� 0 3 Pumper N 0 -4 -'?,H L -4,,J D AT INSPECTION gas/c3 f 1 q ft. S. g.p.m. Other bacteria U colonies/100 ml. Collected by: S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Date installed /0 /1 CI A / Cieanout�( /N) Y i S High water alarm (Yo Ny LfMi°i.V(_ S/LRvircE C. ABSORPTION FIELD DATA Date installed) 0/11/1 1 Soil rating (g.p.d./ft2 o ft2/bdrm -Lr System type 74 Cv c - Length a- a ft. Width .3 ft. Gravel below pipe ft. Total depth ft. Eff. absorption area a `>' ft2 Monitoring tube Yk S Depression over field A,' O Date of adequacy test '?6- S/o 3 Results Pass Fail) Ph For 3 bedrooms Fluid depth in absorption field before test 11 in. Water added 7F'ga1, New depth 7 in. Elapsed Time:G 0 min. Final fluid depth _a- in. Absorption rate >= l/ S-0 d. 9•P• Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNo w A-- If yes, give date ` D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' E. SEPARATION DISTANCES Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 9 ,� Absorption field on lot /0 3 Public sewer main N /,4 Sewer /septic service line as High water alarm level at Meets alarm & circuit requirements? On adjacent lots 9 T / F-9 On adjacent lots y 5 '-A Public sewer manhole/cleanout A11.4 Holding tank N �� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 30 Property line Absorption field Water main PJ � A Water service line /o t Surface water J00 Wells on adjacent lots $ S� SEPARATION DISTANCE FROM ABSO�PTION FIELD ON LOT TO: s '( a2 INsr. 4kjeeAy I Property line Building foundation 30 Water main Water Service line ° Surface water 100'+ Driveway, parking/vehicle storage �Q Curtain drain NJ1,JG kNd wi/ Wells on adjacent lots S 7 F. COMMENTS ' ' >E K W JWoo C. `f' � v I„Sp�cTraN <;Cp0AT IvoicATE 5 l+j MONlti.4r,-[ 1//)/c MTgJv2.rf /o PhdP, z G. ENGINEER'S CERTIFICATION in. t certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA uidelines in effect on this date. Engineer's Printed Name Date l► �o HAA Fee $ 3 75-- Waiver Fee $ _ Date of Payment If ff y /O 3 Date of Payment Receipt Number 0 4 Al 5- q Receipt Number (Rev. 12/01) OF ROBERT C. COWAN CE -8801 uo As-13U1/rnLrxx® sn esp L r OF: LEGAL CESCRiPnav: °�*•�" •' MICHELA C:ULVGR f°•i1 o0v @uawat `� with MS1A REAL ESTATE "'� • 11p1 O LOT 22, BLOCK 6,• EAY ECN IN t«t clN • NWct ww. M u.i LY _ t— * — SURVEYORS-7LANNERS-ENC91EE.4S YprIY •1 WM M InJ YM� .y b!/ M. tiY0.Ywf•1, PININ Nr.r, 1,... — 10. / 103 D rL .a..n w eve r. rMi .... M n11pL,tAlMnl, N.I MMr CEO($- _ LAKE SUED. N0. 2 �- 59593 562-5291 _(IoxJS61•�R626 AN [xnutoN Nm[: q.. u,i .,,,�� ,•„�,,,4,,,r n N�r•na.. 1.. .,,.,.,,, �„„L�_ y� N h, t04'intnlL CCw 1•••29' ,nrvE 19. •_ - -1l6 rNL YK "DIE: V.dl .Ilryq NntM, I Y.N.199C2j2i N G bL Gi.YL Ir e,N b ,.uwtw. r 4• ,aelY.yn� rNrl. SML E Y"C S1MgPW5 49 T ih L OrttYor' LOT 2 a'sy'' •.......•• ' ' LOT 23 1`� •U�orrr�o N 9010000' 135.00' b U T mQ Q 30' 0 40.3 a I LOT 22 n n r1EXISTING •'1 •i/' 0 ao 283 n HOUSE N/ X LOf 3 3 N EXISTING r!:.::.... .. o n GARAGE N _.... 40.2 0 � % las 28.3 ..: .:.: ��s':�:..... .... :.. ..... o V7 Ir1 frl II990L`0'(NJ-E135.00 A9JON N oR vE 30' LU f a I I LOT 21 As-13U1/rnLrxx® sn esp L r OF: LEGAL CESCRiPnav: °�*•�" •' MICHELA C:ULVGR f°•i1 o0v @uawat `� with MS1A REAL ESTATE "'� • 11p1 O LOT 22, BLOCK 6,• EAY ECN IN t«t clN • NWct ww. M u.i LY _ t— * — SURVEYORS-7LANNERS-ENC91EE.4S YprIY •1 WM M InJ YM� .y b!/ M. tiY0.Ywf•1, PININ Nr.r, 1,... — 10. / 103 D rL .a..n w eve r. rMi .... M n11pL,tAlMnl, N.I MMr CEO($- _ LAKE SUED. N0. 2 �- 59593 562-5291 _(IoxJS61•�R626 AN [xnutoN Nm[: q.. u,i .,,,�� ,•„�,,,4,,,r n N�r•na.. 1.. .,,.,.,,, �„„L�_ y� N h, t04'intnlL CCw 1•••29' ,nrvE 19. •_ - -1l6 rNL YK "DIE: V.dl .Ilryq NntM, I Y.N.199C2j2i N G bL Gi.YL Ir e,N b ,.uwtw. r 4• ,aelY.yn� rNrl. SML E Y"C S1MgPW5 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 13 HAA # 1 GENERAL INFORMATION Complete legal description or 6 Sand T.akp Suhdivision #2 Location (site address or directions) 8230 Wilcox Street, Anchorage, AK 99502 Property owner Mike Wagner Day phone 248-5680 (h) Mailing address2220 ;}l -r -ox Street Anchorage, AK 99502 ing, to the,legc YPE OF WASTEWATI Individua n, provide written confirmation'trom Stal atus of system .'j,' xxx 7� 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 of this Health Authority Approval application 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 S & S ENGINEERING Phone �� — °2% -761 17034 Eagle River Loop Road No. 204 Address Ea le RIM eska 995 Engineer's signature _ Date 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: W Additional Comments Municipality of Anchorage ® Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: N17 5�� 2,�7 2/ Parcel 1. D. Ol / /33 kS A. Well Data Sewer service line WATER SAMPLE RESULTS: !�-0 4- Petroleum tank I vo"F_ Coliform 0 Nitrate NON - ��F3OtED Other bacteria d Date of sample: I (� I c l' 1 Collected by: S C B. SEPTIC/HTANK DATA Date installed `U_1`1_g Tank size 100660-(_ Compartments Cleanouts Y/) Y Foundation cleanout (Y,�I �&I o Depression (Y/ { So High water alarm (y 1,3/p, Alarm tested (Y/N) Date of pumping MA -z 1,%y Pumper _TS,4A�-,S SEPARATION DISTANCES FROM SEPTIC/F{-TANK TO: Well(s) on lot On adjacent lots Foundation "�o To property line S Absorption field Water main/service line 0-10 Surface water/drainage 1()b ' -f 72-026(3/93)•Front 7* wfl1UlE25 CONTINUED ON BACK PAGE C, ADEC letter. ADEC system number �I,,4 Well type If A, B, or attach Dwater r-aa=� Log present (Y/N) i_ yvo) Date completed /o ao 8/ / -/S- Driller 1A1, W, f) - 11V4 -73L "/t //2iva�,x Total depth�� 2-_ Cased to Casing height Sanitary seal 6)N) � S Wires properly protected ON) �� e FROM WELL LOG AT INSPECTION L N o Date of test I -i5 -S2 /II'moo b / o 9 Static water level f a O r Well flow g.p.m. �,O a g.p.m. ¢ W u � 6J u c` Pump Ievell SEPARATION DISTANCES FROM WELL TO: Septics tank on lot p� ct ( a ; On adjacent lots Absorption field on lot f U3 ; On adjacent lots Public sewer main )-J/A Public sewer manhole/cleanout / Sewer service line WATER SAMPLE RESULTS: !�-0 4- Petroleum tank I vo"F_ Coliform 0 Nitrate NON - ��F3OtED Other bacteria d Date of sample: I (� I c l' 1 Collected by: S C B. SEPTIC/HTANK DATA Date installed `U_1`1_g Tank size 100660-(_ Compartments Cleanouts Y/) Y Foundation cleanout (Y,�I �&I o Depression (Y/ { So High water alarm (y 1,3/p, Alarm tested (Y/N) Date of pumping MA -z 1,%y Pumper _TS,4A�-,S SEPARATION DISTANCES FROM SEPTIC/F{-TANK TO: Well(s) on lot On adjacent lots Foundation "�o To property line S Absorption field Water main/service line 0-10 Surface water/drainage 1()b ' -f 72-026(3/93)•Front 7* wfl1UlE25 CONTINUED ON BACK PAGE C. LIFT STATION `v1A Dat�insttalled Size in gallocc�, Vent (Y/N) High water alarm level Meets MOA electrical codes SEPARATION MTV! I I on" level at E FROM LIFT STATION TO: On adjacent lots Manufacturer Maghoie/Access (Y/N) "Pump off" Level at _Cycles tested Surfacewa1 D. ABSORPTION FIELD DATA \ Date installed 1� �`�/ Soil rating (GPD/Ft2) System type LengthWidth 3 Gravel thickness 6 _Total depth �O Total absorption area r� 69 SF Cleanout present Y%) MT on,c y Depression over field (YQ /U) Date of adequacy test I d c Results (pass/fail) l F1SS for 3 Bedrooms Water level in absorption field before test Df -,-y After test j Peroxide treatment (past 12 months) (Y(O, yWT �r�owo If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 103 To building foundation On adjacent lots_ On adjacent lots 3S'* Property line To existing or abandoned system on lot 0 Cutbank /J/ i _Water main/service line old f� Surface water _ 10d /' Driveway, parking/vehicle storage area Curtain drain �31A E. ENGINEER'S CERTIFICATION I D '-f f certify that / have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name /l app T— CoZ✓ri J t y A 10 -:I, aoeCr IIEO COWAN Date HAA Fee $ dO Waiver Fee $ r Date of Payment 1d.1 /� Date of Payment Receipt Number 7 Al Receipt Number 7L 72-026 (3/93)' Back ® Mtniieipality of Anchor -acre e Department of Health and Human Servicesh5j 825 "L" Street Rick Mystrorn, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 January 5, 1995 Mr. Robert W. Cowan S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River, AK 99577 Subject: Waiver Request for: Lot 22, Block 6, Sand Lake Subdivision #2 Waiver Approval: # WR940069 Dear Mr. Cowan: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are: Well on Lot 22 to Septic Tank on Lot 22 92 feet Well on Lot 22 to Septic Tank on Lot 23 98 feet Well on Lot 22 to Septic Tank on Lot 21 89 feet Septic Tank on Lot 22 to Well on Lot 21 88 feet Well on Lot 22 to Absorption Field on Lot 21 85 feet Absorption Field on Lot 22 to Well on Lot 21 87 feet This waiver approval applies to the existing septic system to well separations only. Any future upgrades will require all separation distances be met or another approval be obtained from this department. Sincerely, b��- ( 9 4e"'� Daniel J. Roth Civil Engineer On -Site Services kb MUNICIPALITY OF ANCHORA6' Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR940069 PID# 011-133-15 HA# HA940684 Permit # Date Received: 12-15-94 Legal Description: Lt. 22, Blk. 6, Sand Lake Subdivision #2 Engineer: S & S Engineering 17034 North Eagle River Loop, Suite 204 Eagle River, AK 99577 Applicant: Mike Wagner Well on Lot 22*f6*9eptic Tank on Lot 22 - 92 feet Well on Lot 22 to Septic Tank on Lot 23 - 98 feet Waiver Requested: We 11o, ret 22 to Septa Tank An Tet 21 - Rg feet Well on Lot 22 to Leachfield on Lot 21 - 85 feet LeaUhfiE_-td on Lot 22 to Wett on Lut Septic Tank on Lot 22 to Well on Lot 21 - 21 - 87 feet 88 feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: S'6F7 jzC/-/1:�/� Date. /Z -Z 7-9C Rec #: 00557 (641748) Amount: $_920.00 of Reviewer Date Paid: 12-15-94 w,��VER REQuEsr Fon SOT 22 l31k 6 SHivD L.�kf Su/90. #2 wlglvER REquEsr m urteElz w1?94006 q w19IvEn I?EouE5T Fon TR F- bF`LS /o-, z Lq 6 / i s-/ 3 Tk� w FLL1 Hka,F ANNnc6nOK? 1,?YAE :! DF , lC /�i 84 rwP- Ea � /� vu.•n su/PF.9c r s' I/(F W F L L o N G O T 2 2 13 L /< 6 Si3'N 0 L 9*F 2 7'0 >9TER APu/FF/PS, C. ELL J N� N/Tn SEPr,c TAXIk ov LoT 22 VLk 6 72 F,ErT /%'[FSrE.a, r, 2. 5EPric 7AAlk ov 1OT 23, 0 L 6 rs 99 FEET 1 S E PTI c i,9Nk o�v 1 Or 2 I/ 041e 6 8% ffE % �o< ¢, SEPr/c fYl sORp)/acv F/6Lli 0A1 /Or 2f, 84k G @ 85- fT CFACHFIE40 ON L07' 22 0Lk 6 S6AE 02 7 N== , - _ J:PRr✓wrE WELL ON Lor 2 Rd-& 6 `i SEPTI c Tl4,vl< ao L or 22 . 6W? 6 S/sA q LARE&2- TU 6. Pnl v,9 rF w E LL ON Lor 2/ Bok G @ 88 FEET SFpr<< nra-T 4 0r9-74 — rkF SF_pr/L SYS TF MS Ov LorS 2 22, ` 23 WERF- .¢LL ok"4 QY 7 -fe- s,ImE P6?lov /4r r/-cF Sl;A4F T/titEr }1L L / Te M! FIQL. pUCu�+ENncO BY in�JPfcTanJ FJ�OM r/ -LF_ /i D, R, fJS sfw F_AICY�0,4C/f/Aly /7PAr20xrnt.9t'GLr' /PS 1/STF� A(30✓ET/{/J /S ' /1NvrHer/ T1'✓'✓c,4L S/jupraA, /,v J;,�tid L/q({g SucalviV,11v rkE l/fny LuTS /NvatvED 6-o`Y /PS--' Tt'Prcpc) TR F- bF`LS /o-, z Lq 6 / i s-/ 3 Tk� w FLL1 Hka,F ANNnc6nOK? 1,?YAE :! DF , lC /�i 84 rwP- Ea � /� vu.•n su/PF.9c r s' I/(F }�aroliL,E >9TER APu/FF/PS, C. ELL f/�L/4pi- 6' !w/2/ci, i E N� N/Tn pr-- TEN a rv�/Fo,q,�c /%'[FSrE.a, r, ZZ . DF /f, IJ. F. C. S, D, W, A o�� SonBr�o.v coo 1 /2.s -k 6,0 zv� _ 00 LA?rt /Lf ry 2a G 1 206/ 61-f / flSSuM� COniJ�ErgJ�ri✓�' �� , f-/(1�lZa�vr/�-L SEPh+R�To�1 /1SS k n 1E w Off e clrsF CUNCLU. f/Ba 6 fiAA(r N-41vr-R 7 -Or S. �.---�. v• PO / /v TS 76 2.01 /.0/ 2.9 2.4 G�?�ti ror�t 17.1 S&SN �ineenTnG ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS December 12, 1994 (907)694-2979 FAX (907) 694-1211 HEALTHAUTHORITY APPROVALS E RECIVE D RECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street DEC 1 51994 PO Box 196650 SEWER&WATER MAIN EXTENSIONS Anchorage, Alaska 99519-6650 mu, McliPWity of Anoht)r�ge �4i�tii$9i(i1 A i' uman S envicas REFERENCE: Lot.22, Block 6, Sand Lake S/D #2 8-230'Wilcox Street, Anchorage SEWER&WATER - INSPECTION Request you issue the attached Health Authority Approval for the referenced property and grant the following separation ENGINEERING STUDIES distance waivers. ANDREPORTS PRIVATE WELL ON LOT 22; BLOCK 6; SAND LAKE #2 to: 1,/1.) Septic tank on Lot 22, Block 6, @ 92 ft. WELLINSPECTION L��) Septic tank on Lot 23, Block 6,. @ 98 ft. &FLOW TEST 3.) Septic tank on Lot 21, Block 6, @ 89 ft.*** 4.) Septic Leachfield on Lot 21, Block 6 @ 85 ft.*** SITE PLANS LEACHFIELD ON LOT 22; BLOCK 6; SAND LAKE #2 to: 5.) Private well on Lot 21, Block 6, @ 87 ft.*** ROAD DESIGN SEPTIC TANK ON LOT 22; BLOCK 6; SAND LAKE #2 to: �6.) Private well on Lot 21, Block 6, @ 88 ft.*** SOILTEST *** approvals have been previously issued by the M.O.A. PERCOLATION TEST In reviewing the files for each property it appears the several of the separation distance violations were noted and STRUCTURAL& MECHANICAL approved by the Municipality. However, the "Municipal INSPECTIONS Waivers" were issued prior to the State Department of Environmental Conservation giving the Municipality the authority to issue waivers. ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 99577 Page 2 Lot 22, Block 6, Sand Lake SID #2. December 12, 1994 Information obtained from Municipal files show that the following separation distances have been approved. 1. The distance between the private well on the referenced property and septic system serving Lot 21, Block 6 Sand Lake #2. This distance is documented as approximately 90 ft. See attached inspection for Lot 21, Block 6, Sand Lake #2. 2. The distance between the septic system serving the referenced property and the private well on Lot 21, Block 6, Sand Lake #2. This distance is documented as 95 ft. See attached inspection report for Lot 22, Block 6, Sand Lake #2. A Health Authority Approval was issued for Lot 21, Block 6, Sand Lake SID #2 on March 21, 1984. Since the Municipality already issued approvals for the septic installations for Lots 21 & 22, Block 6, Sand Lake SID #2; we are requesting you issue formal written waivers for the each of the existing well and septic encroachments between Lots 21 & 22. These requested waiver distances are followed by asterisks "***" on page 1 of this report. Actual waiver distances are shown on page 1, the separation distances shown on the attached site plan are distances measured from the septic stand pipes; the waiver distances have been adjusted for trench width and tank width. (See attached site plan). Request you issue waivers for the following septic system encroachments within 100 feet of the well serving the referenced property: 1.) Septic tank serving the referenced property at 92 ft. 2.) Septic tank serving Lot 23 , Block 6, Sand Lake SID #2 at 98 ft. Page 3 Lot 22, Block 6, Sand Lake S/D #2 December 12, 1994 GENERAL WELL INFORMATION The well serving the referenced property was installed on October 20, 1981 by Water Well Drilling (W.W.D.). The well was originally drilled to a depth of 80 feet. On December 23, 1981 the well was deepened and cased to a depth of 288 feet. A flow test, performed on November 30, 1994, shows the referenced well to be producing 6.0 gallons per minute with an 39 ft drawdown. The static water level was measured prior to the flow test at 118 ft below top of casing. Water samples were collected on November 18, 1994 and were tested for coliform bacteria and nitrates by Commercial Testing and Engineering. The results were satisfactory. GENERAL SEPTIC INFORMATION The septic system serving the referenced property was installed on October 19, 1981. The system consists of a 1000 gallon septic tank followed by a 22 ft. long leachfield trench. An adequacy test performed on the septic system on November 30, 1994 determined that the system is functioning properly for a three bedroom house. We believe a waiver of the 100 ft. separation distance from the well serving the referenced property to the septic tank serving the referenced property and the septic tank serving lot 23 should be granted for the following reasons: 1. The waivers are for septic tanks only. Generally a septic tank is not considered to be a continuous source of contamination. 2. In reviewing several well logs for the area it appears there exists several clay layers between the ground surface and the water supply aquifer. 3. Satisfactory bacteria and nitrate results have been collected from the referenced well. Since nitrates were undetected, there is virtually no effluence from septic effluent. Page 4 Lot 22, Block 6, Sand Lake S/D #2 December 12, 1994 4. The well log indicates the well serving the referenced property is cased to its full depth of 288 ft. The current static water level is at 118 ft. below ground level. Surface water or septic tank effluent must filter through over a 100 ft of receiving soils before reaching the aquifer. Contaminants will be removed before reaching the aquifer. 5. The ground surface at the well head is approximately at the same elevation as the ground surface at the septic tanks located on lots 22 and 23. The ground vegetation between the well and septic tanks consists of a well groomed lawn. In the event of surfacing effluent from either of the septic tanks, the effluent would be readily noticed. 6. Records on file for lot 22 show the septic system receiving soils to be rated at 85 sq. ft. per bedroom. This type of soil is generally very effective in filtering harmful effluent contaminants from water as it passes through the soil. If you have any questions or require additional information for your review please contact us. incerely ah'V4 UU SCI JAMES P WILLIAMS, C.E. ROBERT C. C WAN, P.E. co O .O �.� a J'J 0 O F d' rn � No oz N w z V 0 O �3 aa` N o ao zza� �a- WILCOX TRE 7 I— 0Q ZUvta- O wovt � J t ce w � z S21 o ¢ z > Y t - a - m w pp ) � Q U z w.w>-L�.mHO I Nw L-- 7 v)w0ZLaa� �QVI NYa w0 V�' cy O \ 2 ZN(nZZ �� b� F VW) U ~ w Lu W LLI 0 �0 to o° N o L`'zDQ] > viv � � v soma= w� w w �SIIOH ti �a �z� m Do¢:<�rQz F co H o ZSI a Cl) (nVQ ~'O�o OU N W x N W `�, N z �> LJ O Y N o° o Q e� .y Z Q o FI 89.1• z J D f" b7 `�b7 67 fi i� t 4t U �P 3ltlOS NVld ]LI] 09 = „L a w ¢ a �- N U �a �WiAW M Timed Timene ii dU4 e� Date Date Date 1 - Inspector Inspector Inspector 4-A �YCt � Comments Conditional Approval DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION JAN � 198% RECEIVED Date Sewer Installed Permit No. Septic Tank Size_ -. Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to TankF APPLICANT FILLS OUT LOWER HALF ONLY - Property Owner Phone Mailing Address Buyer Address Lending Institution RS f �R f� oN�l� 7/ �/I/�/ Phone Address -36 B- C. P4 ll/G%i, a C'ff (V 2 0 Realty Co. & Agent Phone Address Legal Description 7 e Street Location +� *Ndj w I [�� y Type,jD Residence rn Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water $apply In Individual ATTACH WELL LOG. A well log is required for all wells drilled since June ❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if ❑ Public Utility available. Sew �g9 Disposal 'Findividual g 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.