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Home My WebLink AboutSOUTH LAKEWOOD HILLS BLK 1 LT 7South Lakewood Hills Block i Lot 7 #015-151-08 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION • I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 2644720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE I EW _ UPGRADE MAILING ADDRES6 22 -3 S a7,,7,-.-2 /e Z 1062J Qx, - � LEGAL DESCRIPTION �Q_1QJwLI Q � V w""" LOCATIONNO. OF BEDJ^ OMS Well vp Absorpti�.on y Dwelling PERMIT NO " DISTANCE TO: OC/ O a D 2 wY Manufacturer A _ ?' Material No. of co partments � Liq. cappcit inyallo ns IF HOMEMADE: 1^s'tle length — Width/ LigW"epth d [7Y DISTANCE TO: Wel Dwelling PERMIT NO. O Z QManufactu Mat IiaLiquid capacity in S H O Wel Foundation s Nearest lot line PERMIT W = DISTANCE TO: �L LL = No. of lines Length o each line Total length of lin s Trench width Distance between li e,; 1 G✓ d e" Inth@5 �2W A j: p Top of tile to finish grade "Jr5 Material beneath the finches Total effectve ab orp io9 area (O , Length Width Depth PERMIT NO. W df Type of crib Crltrdlam er Crib depth Totel effective absorption area C W r" Well Building oundation st lot line a DJS NCE TO: Depth Driller Distance to lot line PERMIT NO. J J W Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS � 41' ?S 3 Y SOIL TEST RATING /Q� INSTALLER REMARKS ✓� n �' �+2. — 7•S � V, 15 PP VED _ DATE LEGAL // '72-013 !FyV.3/7W meNin c) i 19 1 r-4 54: o U3 F. P2 o F. P2 rl U r_l I C I . 1-f L I IF Q F- H t -J 1::: 1-, ,1 F. F=-1 ID E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-47^20 64ELL FAr-JE• EDrA `= I TE = E14QF: F"EF:tl I T PERMIT NO. < 790533 ) APPLICANT HAROLD HORNET: PO BOX ?-79:5 274 2186 LOCATION O'MALLEY A RIDGEVIEW LEGAL L7 E1 SOUTH LAKEWOOD HILLS SZD LOT SIZE 15=+00 SQUAPE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: DPAINFIELD MAXIMUM NUMBER OF BEDROOM': = 3 SOIL RATING <SO FT/EP)= 100 THE REOUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: c LEr-JGTH= - GF< H'•. EL GEF TH= _ . THE LENGTH DIMENS=ION IS THE LENGTH (IN FEET) OF THE TRENCH OR. DR:AINFIELD. THE DEPTH OF A TRENCH OR, PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE TF? ErJr_-H 1.1 I E-TH I' - . CAC -10 F EET THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCA'•iATION (IN FEET). F.- 1=_Q J I F? EES SEF TIC TFir-JK _• I =E= 1-C-100-1 c:3F-iLLOt-J::,:' PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE --- TWO C 2" ] I tA">F•ECT I CirJ:L-- FiF? E F? EIDU I F:EF? --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL: OR: 150 TO 200 FEET FROM A PUBLIC WELL DEFENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS APE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS APE AVAILABLE TO INSURE PROPER INS=TALLATION. F EF: pi I T E:^:FP I FR_ E= E•ECEt•1E:EF? = -1 s ::L,. -=l r _=4 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REOUIPEMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INS=TALL THE SYSTEM IN ACCORDANCE WITH THE CODES. _: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY R.EOUIRE ENLARGEMENT IF THE RESIDENCE IS .SMO - - -D TO lCLUDE MORE THAN 3 BEDROOM-. o`,�.P•1ti.cQ� o� SIGNEI:- -- ----------------------------------- APPLICANT HAROLD HORNER: ISSUED E'r' -------------DATE---tor + 1- --1--- o Aj- 3:,§ Z _ �- -- L = �3 n ya SOILS LOG �`OO\ MUNICIPALITY OF ANCHORAGE PERCOLATION • '//�� \1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST Pouch 8650, Anchors". Alsaks 99502 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Htit�n LD DATE PERFORMED: /`/— LEGAL DESCRIPTION: 7 /9/ SO (,Q ALL W Cc%O HILL S SLOPE SITE PLAN 1 2 3 51 I S'Arlh (Gw—sW)�i�0) I 6 7 1 8 91 .1 1 zso �. 10- 11 - 12- 13- 14- 15- 16• 17 18 19 20 COMM CSMA S GROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? No SL O P E Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: J /-11' v % CERTIFIED BY: )'1�-DATE: /n 7 / 72008 (7/76) \0 p r r0 Pa.•t9 r • - (o --Lto ( t':Iy DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME [3 One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five DATE ❑ Six DATE 3DATE ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well INSPECTOR INSPECT INSPECTOR Al MUNICIPALITY OF ANCHORAGE DEPT. OF I:.-ZT i & PROTECTRFJIWRONMENTAL FlJTLCTION DEPARTMENT OF HEALTH & ENVIRONMENTAL 825 L Stmt • Anchorage, Alaska 89601 • MAR 71980 ENVIRONMENTAL SANITATION DIVISION Telephone 2644720 R E C E l E D_ _V_ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES • DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be procaaed. Please allow ten (10) days for processing. 1 1. PROPERTY WNER ez);n L. H ogPe PHONE AILING ADD SS yT �1O2 r n5DI H01 x -39P5 r y PROPERTY RESIDENT (It different from above) PHONE 2. BUYER / H N MAILING ADDRE S r 3. LENDINGINSTIT N / -/ j f PHONE MAILING A DR S 4. REALTORM PHONE MAILING ADDRE S t':Iy 72010 (Rev. W791 MJ STREET L A7ION,�vr�� I 1 \ L7st�L 6. TYPE OF RESIDENCE NUMBER OFsBEDROOMS [3 One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILYThree ❑ Six 7. WATERS PPLY INDIVIDUAL' a ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM - -Ie< INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. W791 MJ _ THIS SIDE FOR OFFICIAL USE ONLY _ 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMITNUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED \ div 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING O 0 ❑SepticTankor ❑Holding Tank Size: !_1 SC If Tank is homemade give dimensions: TYPE OF TANK MANUFACTURER n TOTAL ABSORPTION AREA MATERIAL V 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS S3' APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72010 (Rev. 6/79) n CHEMICAL & GL ,LOGICAL LABORATORIES k,,F ALASKA, INC. TELEPHONE (907)-279-4014 ANCHORAGE6633 BSINDUSTRIAL CENTER 274.3364 .l._ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER II TO BE COMPLETED BY LABORATORY WATER SYSTEM: I I I I I = . I I.D. NO. Water Phone No. Mailing Address city State Zip Code SAMPLE DATE: = E- .D t) Mo. Day Year SAMPLE TYPE: 0 Routine ❑ Check Sample (for routine sampler Treated Water ❑ Special Purposee With tab ref. ❑ Untreated Water SAMPLE NO. LOCATION 3 4 5 I READ INSTRUCTIONS , BEFORE Time Collected Collected By %d:3n r: r'. Analysis shows this Water SAMPLE to be: ,Q Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit: sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received /^ Analytical Method: O Fermentation Tube Membrane Filter Lab Ref. No. Result* Analyst I I m U m L -_j m euo M C~*5i100 mi. ar NO W eoe,M 0anwm. 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1976 Date Collect40 Source a.m. EMs Brom 24 Boum ur4rn 44 nwo, COLLECTING SAMPLE Mu1ep44 Tube Report, 10ml Tubes POYtMRotel SOMI Perthrrut Membrane Pacer, Dimt Count conform/100MI verification, LTB Y. Final Membrane Fater Rewits 11 co11f0Im/100m1 RepMltlBY Dab •tet, TNn4- a.m. P.M. Municipality of Anchorage ••, n • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.enchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING /I Parcel I.D. 015-151-08 HAA# LN 1. GENERAL INFORMATION Expiration Date: �z' % is — 0 S Complete legal description SOUTH LAKEWOOD HILLS SUBDIVISION $i: LOT 7. BLOCK 1. ❑ Public Water System ❑ Location (site address or directions) 6500 O'MALLEY ROAD + ANCHORAGE. AK. 99507 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address LANCE AND SUE DILLEY Day phone 770-5795 6500 OWALLEY ROAD * ANCHORAGE. AK. 99507 Day phone LISA CONNER W/ DYNAMIC PROPERTIES Day phone 3111 OC' STREET * ANCHORAGE, AK. 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well N Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage riles 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 ofinstallation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. fie operational life of all wells and septic systems depend on the focal soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authodzed, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date - 1012,410 Conditional approval for bedrooms, with the fllowing stipulations: Note_ The well for this property meets existing State and Municipal Codes. There are nitrates present. It Is suggested that periodic testing be performed to insure the wells continued suitability. Current nitrate concentration Is 5.01 mg/i. EPA maximum concentration is 10.0 mg/l. More information on nitrates Is available from the On -Site Services Program, at 343-7904. Attachments: HAA Checklist C/ Manitenance Agreements Septic System Advisory Supplemental Engineers Reort t/ Well Flow Advisory Other By: Original Certificate Date: O q (Rw. 1201) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water 6 Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SOUTH LAKEWOOD HILLS S/D #1; LOT 7, BLOCK 1 Parcel ID: 015-151-08 A. WELL DATA Wed type PRIVATE If A, B, or C provide PWSID# N/A Date completed 10/26/79 Sanitary seal (Y/N) YES Totai depth 177 ft. Cased to 177 ft. FROM WELL LOG Date of test 10/26/79 Static water level 9 —ft. Well production 50 9— p.m-WATER SAMPLE RESULTS: Coliform n colonies/100 ml. Nitrate -6-4Lmg./L. Well Log (YM) YES Wires property protected (Y/N) YES Casing height (above ground) 30.5 in. AT INSPECTION 10/12/2004 103 ft. 3.4 g.p.m. Other bacteria _&L__colonies/100 ml. Date of sample: 10/12/2004 Collected by: G.E.G. Ltd. S. SEPTIC/HOLDING TANK DATA Tank Type/Material PLASTIC Date Installed 10/22/79 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YM) N/A 1 Date of pumping 10 2004 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA Date instatled 10/22/79 Soil rating (g.p.d./R'or® 1100 System type TRENCH Length 48 ft. Width 3 ft. Gravel below pipe 3.5 ft. Total depth 5.5 ft. Eff. absorption area 336 ft' Monitoring tube "ES Depression over field NO Date of adequacy test 10 2004 Results (Pass/Fad) PASS For 3 bedrooms Fluid depth in absorption field before test "? 3 in. Water added 502 gal. New depth".=27k1. Elapsed Time: 163 min. Final fluid depth 211 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - **SUMP ONLY EXTENDS 25.5 INCHES BELOW INVERT. •0•1.5 INCHES ABOVE INVERT. r D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at in. Cycles tested Meets alarm 8 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfiifi station on lot 102' TO PIPE Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 700'+ Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 100+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage 50'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I car* that I have determined through field inspecWns and t 7.7 review of Municipal records that the above systems are in """ conformance with MOA HAA guidelines in effect on this date. Engineers PrintA ed Name JEFFREY GARNESS / Date /0 / 4 14o!4 TiKvp � s 6� HAA Fee $ 43o — Date of Payment k )I <10q Receipt Number6(4,�)Li' it (Rev. 17100) Waiver Fee $ Date of Payment Receipt Number GARNESS ENGINEERING GROUP, Ltd CONSULTANTS & GENERAL CONTRACTORS October 13, 2004 Lance & Sue Dilley 6500 O'Malley Anchorage, Alaska 99507 REFERENCE: South Lakewood Hills #1 Subdivision, Lot 7, Block 1: Well and Septic System Evaluation, and Upgrade Proposal for a Septic System Serving a Single Family Residence within the Municipality of Anchorage (MOA). Dear Mr. & Mrs. Dilley, ZPer the request of your agent, we inspected the well and septic system which serve your property for the purpose of obtaining and MOA Health Authority Approval (HAA). A site visit was performed on 10/12/04. Our findings arc summarized as follows: n WELL: Prior to the start of the flow test the water level was 103 feet below the top of the well casing (BTC). Water was metered from a hose bib at a rate of 3.4 gpm for 280 qq minutes (952 gallons). The hose spigot was shut off at this time. The water level in the l! casing was 108 feet BTC. Over a period of 280 minutes a total of 952 gallons was X pumped and the level in the casing remained stable. Based upon this data it was determined that the production rate of the well is approximately 3.4 gpm, which exceeds the MOA requirements for a three (3) bedroom house, which is 0.325 gpm. >1�t WATER QUALITY: Water samples were taken on 10/12/04 and taken to a State certified laboratory to be analyzed for nitrates and bacteria. As soon as the results are available we will forward them to you. SEPTIC SYSTEM: Upon inspection it was determined that the drainfield is completely 'r^ submerged in water. This is refcrred to as "surcharged" condition. Although the system p may be functional, it is by MOA definition technically failed and an upgrade will need to 3 h' be performed before you can transfer title (sell) the property. The following is a O summary of the engineering costs associated with upgrading the septic system. • Services to date for the well flow test, water sampling, and preparation of this report: $715.00 • Engineering services to perform soils evaluation and percolation test: $400.00* 3701 E. Tudor Road, Suite 101 * Anchorage, Alaska 99507 Ph: (907) 337-6179 0 Fax: (907) 338-3246 * Website: gatnessengineering.com for one perk test, $250.00* for each additional perk test. • Excavator to dig test holes. The charges for test hole excavation will depend upon the time of year, access to the property, and the location of the property. If a rubber tire backhoe can be used, the charge is $450.00 for the first test hole, & $200.00 each additional hole. • Engineering services to design the septic system: $600.00* this is based upon a conventional gravity flow septic system with no waivers to property lines, surface waters, or nearby wells. • M.O.A. sewer upgrade permit: $460.00* Payable to the M.O.A. • Engineering services to inspect the installation of the septic system and prepare as -built drawings. Assuming a conventional gravity flow septic system with a single trench/bed and no sand filter: $700.00. Upon request, we can provide you with our standard rate sheet which lists the inspection costs for other types or configurations of septic systems. This information is also available on our website at gamessenginecring.com. The cost for the excavator to perform the installation is unknown at this time. After the soils testing and design have been completed, we will provide you with a bid for the installation. If an innovative septic system is required such as an Intermittent Sand Filter (ISF), a BioCycle, or an ADVANTEX' treatment unit, the design and inspection costs will be an additional $600.00. The items marked with an asterisk must be paid prior to submitting the design package to the Municipality of Anchorage. For your convenience, we accept all major credit cards. Upon completion of the installation we will need to prepare the MOA health certificate paperwork and deliver it to the MOA (GEG prcparation/delivery fee of $150.00). The MOA will charge $430.00 to process the IIAA. If you have any questions, please contact us at 337-6179. For more extensive information on septic system testing and design, see our website at gamessengineering.com. We look forward to assisting you with your engineering needs, and will do our best to provide a cost eff4tive solution. 3701 E. Tudor Road, Suite 101 *Anchorage, Alaska 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 0 Website: gamessengineering.com .`. vMir•- Y A - •6NI AJ b9°%J'00'7� OF A so++ $42.772 . k 01, goo t trod W41G&a �j-;gam•.• NU.9]ia3'.i' . ; ,, S. • .t'go !� 'W..».w1 iASEMENTS Of RECORD, OTHER THAN 'HOSE SHOWN ON THE RECORDED 'LAT ARE NOT SHOWN HEREON, f G' I%•% i'`. -J ov t, ve-NT Njatt SLK 0 %%J T NO CORNERS SET THIS DATE 9773 I hereby certify that I have performed a 1Moortagee's in- s eetion of the following described property: 1,_ Qou.rl_i- � Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent there- to, that no Improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska tliI, %/Jt1 ayof P991 L 19 FRED WALATKA & ASSOCIATES Engineers and Surveyors Z•d 6102 -69S -L06 Ja0000 estj R0C:T1 b0 21 AOM Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Jeffaarness Legal description: South Lakewood Hills Block 1 Lot 7 The attached paperwork has been reviewed and is being returned for the following reasons: Original signature or stamp missing on Calculation error in design. _ Additional soils information needed. Water monitoring results inadequate. _ Discrepancy in information submitted. Topographic information missing or inadequate. _ Incomplete; missing Not all septic pipes on Survey Incomplete; missing Need specs showing septic tank in driveway can support Additional adequacy test information needed. _ Water sample unacceptable. Measured/proposed distances/dimensions missing. Locations of all soils, percolation and water monitoring tests not shown. Proposed system too deep for soils information submitted. _ Well log required. Omission in narrative. Insufficient fill over tank or field._ Other. Da 7" A en, fe s7` Name of reviewer: Jeff �To 11/4/2004 V 10 load. pJ:. O� Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK \ Municipality of Anchorage Development Services Department Building Safety Division .. Onsite Water & Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.akus (907)343.7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.�n D, 015-151-08 HAAS #A 010;Q 1. GENERAL INFORMATION Expiration Date: Complete legal description SOUTH LAKEw00D HILLS S/D• LOT '7, BLOCK 1' Location (site address or directions) . 6500 OWALLEY ROAD Current Property owner(s) JACKIE HORNER Day phone 522-2100 Mailing address P.O. 80X 200985 MCH. AK. 99520 Lending agency Mailing address Real Estate Agent Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well M Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health AuthorityApproval 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 verily that based on the Information obtained from the Munldpality of Anchorage riles and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of Installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS. INC. Address 6901 DEBARR ROAD, SUITE 2B . ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting fhls evaluation, AWWC, Inc. attempted Ac protide a thorough, conscientious engineering analysts of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the tes; and separation distances measured to readily ldentirrable lea tures. Tho operational life of a# wells and septic systems depend on the Acca/ soils conditlon, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provldo any warranty or future estimate of how bng the system wlff continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole bonefit of the ownerpsted above. Anyrellanco upon or use of this report by any other person or party is not authorized, nor W71 It confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Phone 337-6179 Date b b of Manitenance Agreements Supplemental Engineer's Reort Other G�4 •.••'' ti0 ON-SITE •••' WATER AND : WASTEWATER PROGRAM B`:� Z�� zf� Original Certificate Date: 6-11-01 !rt«. izvom �/ Municipality of Anchorage o • Development Services Department BWkft Safety DNbton •.. O"Ite Water B Wastewater Program 47W South BmpaW SL P.O. Baas 196850 Mdrore0e, AK 9951S86W w*w.d.aodrorege ak.ue (907) 943.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legaloescription: SOUTH LAKEWOOD HILLS #1 LAT 7. BLACK 1 Parcell 10: 015-151-08 A. WELL DATA Well Mn PRNATE It A. B. or C provide PWSIDN N/A Date Completed 10/26/79 San" seal (YM) YES Total depth 177 fL Casad to 177 fL FROM WELL LOCA Data of test 10/26/79 Statio water level 9 fL Wen production 50 9.p.m. WATER SAMPLE RESULTS: Conform 0 cotonied100 mi. Nitrate 1.28 mpJL. Well Lop (YIN) YES Wires property protected (YM) YES Casing height (above ground) 30.5 in. AT INSPECTION 5/25/01 103 fL 6.76 9.p -m. Other bacteria 0 colonies/100 ml. Date of Sample: 5/25/01Collected by: AWWC. INC. a. SMMCJHOLDINO TANK DATA TankTypw%teterlel PLASTIC Data Umataited 10/22/79 Tank size 1250 get. Number of Compartments 2 Cleanouts (Y" YES Foundatton deanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping 5/25/01 Pumper ISAACS Date Waned 1o/22/79 Son rating (g.p•d 100 System type SHALLOW D.F Lenptlm 48 fL Width 3 R Caravel below pipe —1-51t. Total depth fL Eff. absorption area338 1t' Monitoring lube YES Depression over Held NO Date of adequacy teat 5/25/01 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption Held before teat 2 in. Water added 575 gal. New depth 20 in. ElapEed fie: 15 min. Final Auld depth 12 In. Absorption rate ra 450 9.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN M yes, give date — D. LIFT STATION Data Installed 'Pump on' level at_in. E. SEPARATION DISTANCES Stze In gallons High water alarm level at tn, CYdes Mesta alarm & circuit requirements?_ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank= station on tat 102' TO PIPE Absorption Aeld on tat 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent bb 100'+ On adjacent kris 100'+ Public sewer manhole/dearwut - N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property One 5'+ Absorption field 5'+ Water main N/A Water service One 10'+ Surface water 100'+ Wells on adjacent bb 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parldng/vehide storage 50'+ Curtain drain NONE KNOWN Wells on adjacent bb 100'+ F. COMMENTS 0. ENGINEER'S CERTIFICATION I cwr* that I have determ/ned tVPwh held Inspection and review ofM ...::... un/dpe/records that the above systems are b► .. ........:... conformance wdN MOA HAAgu/deflnes /n effect on Mls date. .. .. . ................ Engineer's Prk1 N me JEFFREY A GARNESS 0 '• Games Vol953 Date L C a �. ••........... �,•� HAA Fee $ __300 . od Waiver Fee $ Date of Payment Co /6IO / Date of Payment Receipt Number 5 413c? Receipt Number ftv.12MM MRY-21-2001 11x30 . FROM gL.PINE GEN CDMZRCTORS IN TO P.01 a110 �l'y N•e w• " /Kl. 31IM4 .� op1 •� r ••••• k o•tss.e. j Iw•� a ear THIS oATa 664UILT NO COt1NEN Aut I tare y�amed • wV W i henbY eerlltp r' ` retlon of the tollaww desert =1 y AneLwSae liernrdlna Tnclnct,Abate•nrltShfb 11tiwo4nndd do menu Situated thereon oto within the VIv'lll adlaeeat�' not owruv •r • enlenu an t re"flr on the propm �71"It edtaaM 0enw t0. that no ImoroVgym In a�lon ar^ M•t tMn.ery ns encroach on thepriog eawlMnY an roadwa7alnty mpt al IndWRW otafoar• •1 • f1e yMted' a► %Mabe „_, iV3^-_+• ,Data rrru,ar;cw •. TnTLY P Al • 1 ' 1 M to a1litMiMTa 0/ IltgOftC. OT:Ii11 �N ' ••MY fa•WW 11Y TH[ rsoomin . Iit�fta •VOW a110 �l'y N•e w• " /Kl. 31IM4 .� op1 •� r ••••• k o•tss.e. j Iw•� a ear THIS oATa 664UILT NO COt1NEN Aut I tare y�amed • wV W i henbY eerlltp r' ` retlon of the tollaww desert =1 y AneLwSae liernrdlna Tnclnct,Abate•nrltShfb 11tiwo4nndd do menu Situated thereon oto within the VIv'lll adlaeeat�' not owruv •r • enlenu an t re"flr on the propm �71"It edtaaM 0enw t0. that no ImoroVgym In a�lon ar^ M•t tMn.ery ns encroach on thepriog eawlMnY an roadwa7alnty mpt al IndWRW otafoar• •1 • f1e yMted' a► %Mabe „_, iV3^-_+• ,Data rrru,ar;cw •. TnTLY P Al M to a1litMiMTa 0/ IltgOftC. OT:Ii11 �N ' ••MY fa•WW 11Y TH[ rsoomin . a110 �l'y N•e w• " /Kl. 31IM4 .� op1 •� r ••••• k o•tss.e. j Iw•� a ear THIS oATa 664UILT NO COt1NEN Aut I tare y�amed • wV W i henbY eerlltp r' ` retlon of the tollaww desert =1 y AneLwSae liernrdlna Tnclnct,Abate•nrltShfb 11tiwo4nndd do menu Situated thereon oto within the VIv'lll adlaeeat�' not owruv •r • enlenu an t re"flr on the propm �71"It edtaaM 0enw t0. that no ImoroVgym In a�lon ar^ M•t tMn.ery ns encroach on thepriog eawlMnY an roadwa7alnty mpt al IndWRW otafoar• •1 • f1e yMted' a► %Mabe „_, iV3^-_+• ,Data rrru,ar;cw •. TnTLY P Al Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY 1 -la 01 O 1�3 APPROVAL CUD FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-151-08 HAA# 1. GENERAL INFORMATION Expiration Date: �3 - ;1.-0 — 6 Complete legal description . SOUTH LAKEWOOD HILLS S/D• LOT 7 BLOCK 1 Location (site address or directions) 6500 OWALLEY ROAD Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JACKIE HORNER Day phone 522-2100 P.O. BOX 200985 ANCH. AK. 99520 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well IS Individual On-site E ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $250.00 at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time ofthe test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefil of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms. bedrooms, with the flowing Phone -337-6179 Date 1 Z t, .7 a/ Manitenance Agreements Supplemental Engineers Reort Other A. �1ness:' –7953 sFO� ePA G (1N-S1TF C ; WATERAND • ) n C) _ PROGRAM ' r;.��0 q(r .—ref i e"�` •• Original Certificate Date: (R". 1380) Municipality of Anchorage Development Services Department Building Safety Division _ On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 www.cl.anchorage.ek.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SOUTH LAKEWOOD HILLS #1 LOT 7, BLOCK 1 Parcel ID: 015-151-08 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 10/26/79 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 177 ft. Cased to 177 ft. Casing height (above ground) 30.5 in. FROM WELL LOG AT INSPECTION Date of test 10/26/79 5/25/01 Static water level 9 ft. 103 ft. Well production 50 g.p•m. 6.76 9- p.m-WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.557 mg./L. Other bacteria 0 colonies/100 ml. Date of sample: 12/10/01 Collected by: AWWC, INC. B. SEPTICIHOLDING TANK DATA Tank Type/Material PLASTIC Date installed 10/22/79 1250 YES Tank size gal. Number of Compartments ? Cleanouts (YIN) Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/25/01 Pumper ISAACS C. ABSORPTION FIELD DATA BELOW FINAL GRADE 10/22/79 Soil rating d.lft'or 7bdrm 100 System type SHALLOW D.F Date installed 9 (9•P• Length 48 ft. Width • 3 ft. Gravel below pipe 3.5 ft. Total depth 5.5 ft. Eff. absorption area 336 ft' Monitoring tube YES Depression over field NO Date of adequacy test 5/25/01 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 575 gal. New depth 20 in. Elapsed Time: 15 min. Final fluid depth 12 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons High water alar level at in. Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot 102' TO PIPE Absorption field on lot 1000+ Public sewer main N/A Sewer/septic service line 25'+ On adjacent lots 1000+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 50+ Property tine 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 1001+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main_ N/A Water service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 50'+ Curtain drain NONE KNOWN Wells on adjacent tots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION •. r 'V field inspections and �:' T 0 I certify that I have determined through review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printe Na a JEFFREY A. GARNESS ff, C 953 ss.• : 00 j� r' �aDOO Date 1 y 1 G �Op°/'.oree�l00040� �00400�� HAA Fee S Waiver Fee S Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12100)