HomeMy WebLinkAboutSAND LAKE #2 BLK 6 LT 4and Lake 2
Block 6
Lot 4
#011 mm 133mm33
Municipality of Anchorage
Development Services Department
Building Safety Division
On -She Water and Wastewater Program. 4700 S. Bragaw St.
P.O. SO', 1%650 Anchorage. AK 99519-W50
www,cl.sn0horage.ak.Us (907) 343-7904 Page of
ON-SITE WASTEWATERDisPOSAL SYSTEM AND/OR WELL INSPECTIONREPORT
Permit Number SWO40441 I e4o
ld� PID Number 01 -133-,'
Ad� Melodie Jackson Wastewater System: [D New Upgrade
Phmto site: 8235S---,:-,,,^,---, , :horage ABSORPTION FIELD
�3 Oo., 10 ii� T —aWOaw Om� 13oew
aft', LEGAL DESCRIPTION 3.0
LM opo'Fe 9.2
6 � 4 ti� ft. Ft.
Towrtiow R -W- Sand LakA N9 4.0 Ft. 5-17
5�: Filsd�d�ajp W� R
— 0.1 Ft. 15.0
Well: [3 New E3 Upgrade mxt,: Ft.
cw$.6� ( 2.5 N�cg�
A. B. x T" D.M Ft. NA FL
Class C well on L t I C� b: Tw,i ab..,� N.
13�. DM D� Ft. 155 Ft' Noe ASTM D 3034 1 PVC Sch 40
C� FL AK Trailblazing ll/moos
TANK
SEPARATION DISTANCES
To Septic []SePUC [jHolding OS.T.E.P.
Absorption Lill Holding
F� Tank Field Station Tank Sewer ure Anchorage Tank & Welding �'y
1500
m
3
'0
0
2
Pet: -P
::: 5 7
4 .0 Ft.
0
Ft 15 0
P� c 25 F NA
0
Fe A TPA D 3034 11
D..
r
2005
155g 8S16
�:�bl�ing
AK Trail
IF tion
M
Sa
wo 104* 97.5* NA 1A..W-W --------
NA 85+ steel -N:;; �dc—p�
2
r
100+ 100+ NA NA LIFT STATION
Lal Lkw 5.5 8.8** NA A NA Gal Orenco
OL F
2 7 R7NA NA w �W - 'P�ar�.t. mo"t.�,,t
fime�, it, timer 1" timer
r
a M� E,� � P.,� by
c—t0— NA NA NA :NA CSI 30-05-11
____ 7
lt� MOA
*ADEC Waivers to Class C wells (attached). BENCH RMARK
**Lot line waiver approved 110-20-2004. front porch
99.63 FL
Engfneer's Stamp
Inspections performed by: Cindy W. Ellis, P.E. Dates: 10 7130/05
49LH**
2,4 7/30/05
Development Services Department Approval
-t � C
Reviewed and approved byi n Y W. Ellis
(R".12ft)%rhF AtfS trar Date: �07 �\-.Cl
4A I C 0--," f& 1`14cer It CE.10M
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41401PA nAl r�.Ift it . 11. �� 0, - - .� 'f J* — — T - 1, . ................
100'well radius
Sand Lake #2,
Block 5, Lot 21
97'well radius
Sand Lake #2,
Block 5, Lot 21
I'l
10 ft to drainfield on Lot 3
I Reserve Site
i
I GRAVEL DRIVE
TH
ater Line
AdvanTex
1500 gat steel tank
with AX -20
100' radius for
Lot 5, Blk 6
Private Well
Sand Lake #2 Block 6 Lot 4
Record Drawing of Septic Upgrade
Bret Kelly
Parcel ID: 011-133-33
Permit No. SW040441
Cindy W. Ellis, P.E.
December 26, 2005
Scale 1 Inch - 20 ft
Q
100' radius for
Lot 21, Blk 6
Private Well
N 90-00'001 135 00'
LJOT 4
3 DR 110USE
/�*\"�'�1100' radius for
Lot2l,lllk6
P0 Private Well
FCO I
90-00,001
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax (907) 349-1934
House & septic pipes
based upon a survey
by Jeff Gastaldi. LS -6091
September 27, 2005
AS -BUILT
A
B
FCO
38.1
3.6
STI
43.3
47.8
MH
50.0
57.2
CO
49.5
63.6
1 MT
1 50.0
163.5
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax (907) 349-1934
House & septic pipes
based upon a survey
by Jeff Gastaldi. LS -6091
September 27, 2005
AS -BUILT
FCO
89.61
NOTE:
RELATIVE DEPTH OF
TEST HOLE = 80.77
NO WATER
FINAL GRADE
ST1 98.71
E:
ADVANTEX MAN -
94.23' AX -20 POD HOLEi
STEEL ADVANTEX TANK
93.61' A 1500 GALLON
N.T.S.
FINAL GRADE = 98.88
FdU=-
FILTER FABRIC
SEWERROCK
MT1 COI
VRL78 �89.83
15.0 1
TRENCH
N.T.S.
NOTE:
ORIGINAL GRADE
98.38 - 98.77
AS -BUILT
Sand Lake #2, Block 6, Lot 4
Record Drawing of Septic Installation
Melodie Jackson
Parcel ID: 011-133-33
Watkins Engineering, Inc.
a
'O"Ar.. 0,
49 THW
Permit No. SW040441
4 ..................
Y W. ELLIS
MET
VEY t 7
Cindy W. Ellis, P.E.
P.O. Box 110443
December 26, 2005
Anchorage, Alaska 99511-0443
No Scale
Phone: (907) 349-1851, Fax: (907) 349-1934
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Frank Murkowski, Governor
555 COMOVA
DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE, AK 99501
1 Phone: (907)269-7519
Fax: (907) 269-7509
DIVISION OF WATER http://www.state.akus/dec/
WASTEWATER DISCHARGE PROGRAM
March 17,2006
Cindy W. Ellis, P.E.
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Re: Sand Lake Number 2, Block 6, Lot 4-Scparation Distance Waiver Approval
ADEC Plan Tracking Number 5375
Dear Ms. Cindy Ellis:
On February 13, 2006 we received a request to reduce the required distance between a
replacement onsite wastewater system serving a 3 bedroom single family home located on Lot 4,
and the Class C public drinking water well on lot 21, block 5, Sand Lake Number 2. The on-site
wastewater system consists of a 1,500 gallon steel tank with an advanced treatment unit (Orenco
AX -20) and a shallow trench type soil absorption system (15 feet long by 4 foot in effective
depth). Construction of the on-site wastewater system was approved by the Municipality of
Anchorage, Development Services Department, On-site Water & Wastewater.
Ile waiver requested is to change the separation distance, which had been reduced from I So feet
to 100 foot, to a field measured 97 feet from the existing Class C well to the existing on-sitc
wastewater disposal system. The waiver is approved and based upon the engineer's
recommendation, soil conditions, well test results, well logs from the area; and the additional site
conditions. Ile waiver approval is granted as follows:
Ile shallow trench type soil absorption system on lot 4, block 6 has been field
determined to be 97 feet from the existing Class "C"well which is located on lot 21,
block 5, Sand Lake Number 2 Subdivision. This waiver allows the construction to
remain at 97 feet from the source.
This approval does not imply the granting of additional authorizations nor obligate any state,
federal or local regulatory body to grant required authorizations.
Any person who disagrees with this decision may request an adjudicatory hearing in accordance
with 18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in
accordance with 18 AAC 15. 185. Informal review requests must be delivered to the Division
Director, 555 Cordova Street, Anchorage, Alaska 99501, within 15 days of receiving the decision.
Adjudicatory hearings requests must be delivered to the Commissioner of the Department of
Environmental Conservation, 410 Willoughby Avenue, Suite 303,P.O. Box 111800, Juneau,
Alaska 99801, within 30 days of the decision. If a hearing is not requested within 30 days, the
right to appeal is waived.
Thank you for your cooperation. If you have any questions please do not hesitate to contact me at
269-7519.
Respectfully,
6�j
William R. Rietl-4 P.E.
Environmental Engineer
cc: MOA, Onsite Program
cc: David Johnson, WW,
MUNICIPALITY OFANCHOIRAGE CO A
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Oct 20, 2004
Expiration Date: Oct 20, 2005
Permit Number: SW040441 Parcel ID: 0 11-133-6& 3 3
Legal Description: ZAND LAKE #2 SUBDIVISION BLOCK 6 LOT 4
Design Engineer: 0855 Garness Engineering Group, LTD Site Address:0 SEAVIEW STREET
Owner Name: MELODIE JACKSON Lot Size: 6750 SO. Fr.
Owner Address: NHN SEAVIEW STREET Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99502 -
This permit Is for the construction of:
[?] Disposal Field [?] Septic Tank E] Holding Tank El Privy E] Private Well Water Storage
All construction must 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, seated, and heated to prevent freezing.
Received By -
Issued By:
Date: Irl h?) h"�
. I
Date:
"'C -- �0 �',t ��
Mayor Mark Begich
Municipa1W ofAnchorage
P.0. N)x 1WCA% - A"homgc, AILLska 90519,C)CM * Telephone VXYD M-M)l 0 rm% (!X)7) 313-82M
4700 Bmgnw Sircct 0 Anchomge,Maska 9'K -*4)7
%�Av.muni.org
October2O,2004
Jeff Gamess
Gamess Engineering Group
3701 E. Tudor, Ste 101
Anchorage, Alaska 99507
Building Safcty Division
Subject: Waiver Request for Sand Lake #2 Block 6 Lot 4
Waiver Request #WRO40077
Parcel ID #011-133-50
Permit # SWO40441
Dear Jeff Garness:
Your request for a waiver of the required 10 feet horizontal separation from the
absorptionfield to property line has been approved. 'Me approved separation distance is
1.0 feet.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
1coodall
Civil Engineer
On -Site Water & Wastewater Program
Community, Security, Prosperity
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. oll -13-3. ---D Permit Number
Property owner(s) MELODIE JACKSON Day phone 248-7000
Waddress (1) 3705 ARTIC BOULEVARD * ANCHORAOF, AK.
Meiling address (2) WH9 %—PUIP-0 'A q4j 602 Zip Code 99516
Legal description (Lot, Block & Sub'd.) t 01 4- PLOCK 61 SAND LAKE S RDIVISION #2
Legal description (Section, Township & Range) N/A
Lot Size tP q5D —AcresISq.Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only
K
Well Only
Sewer and Well
41
Water Storage
Sewer Upgrade
71
THIS PROPERTY CONTAINS:
HotTub
171
Jacuzzi
Swimming Pool
0
Water Softening Unit
0
Therapy Pool
71
I certify that the above information Is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance %vith applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature ef preperty ewnef of eutheF;zed egent)
Permit Fees: qw'—
Date of Payment: I0bqj0q
Waiver Fees*
Date of Payment
Receipt Number 612 , Receipt Number.
V11\
DEPT. OF ENVIRONMENTAL CONSERVATION
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER PROGRAM
http://www.state.ak.us/dee/deh/
October 12,2004
Mr. Jcff Gamess
Garness Engineering Group
3701 E Tudor Road, Ste 10 1
Anchorage, Alaska 99507
Mr. Garness:
FRANK H. MURKOWSKI, GOVERNOR
555 Cordova St.
Anchorage, AK 99501
Phone: (907)269-3076
Fax: (907) 269-7650
Sarah RyghPdec.state.ak.us
File: Sand Lake SID #2 Lots 2, 3, & 4 Blk 6
PWSID: proposed Class C
On October 7, 2004 this office received your submittal regarding your request for two I 00 -foot
blanket separation distance requirements to both existing and proposed septic systems for a proposed
Class C well located on Lot I Block 6 Sand Lake S/D #2 and an existing Class C well located on Lot
21 Block 5 Sand Lake S/D #2. The proposed Class C well (located on Lot I Block 6) will be
converted from an existing private well. According to its well log, the depth is 256 feet below ground
surface (ft bgs), the static water level is 127 ft bgs, and the aquifer is confined by approximately 87
feet of clay. A well log was not included for the existing Class C well located on Lot 21 Block 5.
Other well logs in the area indicate well depths range from 243 to 500 11 bgs, static water levels range
from 113 to 140 ft bgs, and confining layers do exist above the aquifer. Water samples collected on
8/2/04 from both wells indicate neither coliform nor nitrates were detected. Based on the information
submitted, these two 100 -foot separation distance waivers are granted.
The ADEC recommends both quarterly coliform and annual nitrate sampling of both of these wells
based on the number of septic systems and increased development in the area as well as tile number
of wells penetrating this aquifer.
Please also be aware that Class C wells are expected to be reclassified as private wells in the new
regulations package. This expected change will reduce the required separation distance from 150 feet
to 100 feet. Class C well registrations are still being accepted but without the associated fee, and will
be completed on a low -priority basis (the fee will be accepted if the registrations are reviewed).
Any person who disagrees with this decision may request an adjudicatory hearing in accordance with
18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in accordance with
18 AAC 15.185. Informal review requests must be delivered to the Division Director, 555 Cordova
St., Anchorage, Alaska 99501, within 15 days of the permit decision. Adjudicatory hearing
requests must be delivered to the Commissioner of the Department of Environmental Conservation,
410 Willoughby Avenue, Suite 303, Juneau, Alaska 99801, within 30 days of the permit decision. If
a hearing is not requested within 30 days, the tight to appeal is waived.
tj Prirl-C-0 t10 R�:.%Ocd P,!Ivr
Waiver Approval, Sand Lake 02 Class C wells
If you have any questions, please call me at 269-3076.
Thank you,
JOJAV61�L�-
Sarah Rygh
Environmental Engineer Assistant
cc: Jamie Stazel, ADECIMI/DW Program
tl:\Engincer—Correspondence\sr04SandLake2Lots234Bk6Waiver.doc
GARNESS ENGINEERING GROUP, Ltd.
� CONSULTANTS & GENERAL CONTRACTORS
October 1, 2004
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref. Proposed Septic System for Sand Lake Subdivision #2, Lot 4, Block 6,
To whom it may concern:
The proposed 3 bedroom house will be served by a community well and a private septic system.
One test hole was excavated on the property. The drainfield will be designed around the 30 foot
radius of this test hole. We are proposing that a new 1500 gallon Advantex system and a deep
trench type drainfield be installed. Comments regarding the design arc summarized as follows:
1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring,
and the percolation test results.
2. TRENCH DESIGN:
a. Percolation Rate: <1 minutes/inch
b. Allowable Application Rate: 6.0 gallons/day/R2
c. Proposed Application Rate: 3.0 gallons/day/ft2
d. Number of Bedrooms: 3
e. Design Flow: 450 gallons per day
f. Minimum Absorption Area: 150 f12
g. Total Depth: 10 feet (max.)
h. Effective Depth: 5 feet
i. Width: 2.5 feet
j. Minimum Length: IS feet long total
k. Effective absorption area = 150 R2
3. SURFACE WATERS: There are no surface waters within 100+ feet of the proposed septic
system.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengincering.com
4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography in
the area of the proposed drainfield is approximately 10-15% running northeast to southwest. In
eo'�' short, there are no slope concerns.
5. LOT LINE WAIVER: We request a I foot lot line waiver from the north lot line to the
alternate site. We are unaware of any adverse impact to the adjacent properties with the granting
of this waiver.
6. AVELL REQUEST NVArVER: We requested from A.D.E.C., a 100 foot well waiver from
the proposed class "C" well on Lot 21, Block 5, to the proposed septic system on Lot 4, Block 6.
Copies of this requested waiverAill be provided to you as soon as we obtain it.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you Pave any questions, please contact us at 337-6179. Thank you for your
assistance. /I
13161
NOTE. Attached is a site plan drawing, a design drawing, a topography site plan, a soils log,
and a 7 page construction spcciJication letter which are all part of the design package for this
septic system.
3701 E. Tudor Road. Suite 101 *Anchorage, AK99507
Ph: (907) 337-6179 $ Fax: (907) 338-3246 * Wcbsite: gamessenginecring.com
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UARNESS ENGINEERING GROUP
a CONSULTANTS & GENERAL CONTRACTORS Ltd.
3701 E TUDOR ROAD. SUITE 101 - ANCHORAGE. AK QQSO? - IPHMF tQA7l%x7,,,.
MELODIE JACKSON
-. OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM
IONE NUMBER: LEGAL DESCRIPTION:
248-7000 ISAND LAKE S/D
DATE:
10/01/2004
R.A.L.
50,
1 OF 4
LOT 4. BLOCK 6.
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UARNESS ENGINEERING GROUP
a CONSULTANTS & GENERAL CONTRACTORS Ltd.
3701 E TUDOR ROAD. SUITE 101 - ANCHORAGE. AK QQSO? - IPHMF tQA7l%x7,,,.
MELODIE JACKSON
-. OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM
IONE NUMBER: LEGAL DESCRIPTION:
248-7000 ISAND LAKE S/D
DATE:
10/01/2004
R.A.L.
50,
1 OF 4
LOT 4. BLOCK 6.
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laclu RADn
EXISTING PRIVATE WELL
TO BE CONVERTED TO A
CLASS 'c' WELL AND
SERVE LOTS 1. 2. 3.
Lij
4 BLOCK 6
Lli
.
50 WELL RADIUS
E N`W 'N 150- WELL/
0" W LL
50' WELL RADIUS
rK LOID 2� 8 -OCK MIUS
<
KE S/D
cf)
NOTE: TH N TH. SO
AND WEST LOT LINES, AND
WELL RADII SHALL
ALL SHOWN
Lii
PROPOSED
BE FLAGGED BY A REGISTERED
::E 3\8EDROOM
LAND SURVEYOR PRIOR TO
USE
CONSTRUCTION
L 4
LLJ
PROPOSED WATER
UNE LOCATION V*
(f)
w— w — — — — — — --
lool WELL
PROPOSED
WAVER
REQUESTED
N
/3 BEDROOM
HOUSE
INSULATE PIPE
UNDER DR
WTTH 4 INCH
F
ICID INSULATI N
4
&T
FEET WID
I LOT LINE WAIVER
ALTERNATE SITE V61LL
z
REOUIRE THE USE
OF AN ADVANTEX
2� TREATMENT SYSTE M
INSTALL
PROPOSED
DOUBLE
3 BEDROOM
CtEANOUTS
HOUSE
PROPOSED
f
1500 CALLON K'-
ADVANTEX TAN
�PROPOSFD DRAJNFIELD EX CAVA'E
FEET DEEP
A TRENCH THAT IS 10
MAX. BY 2.5 FEET DEEP BY 38
FEET LONG ADD 5 FEET OF CLEAN
WASHED SEWER DRAINROCK.
DATE:
10/01/2004
oF
DRAWN BY:
GARNESS ENGINEERING GROUPp Ltd.
R.A.L.
00,
4 V,
SCALE' .
CONSULTANTS & GENERAL CONTRACTORS -
30'
......... . . . ..... ..... ....
5701 E TUDOR ROAD SlfiTE Wl - ANCHORAGE AK 99507 - �ONF (907)337-6179 - FAX (00?)33A-3?L6
.. .... ........ P
orni ss:
795
PREPARED FOR: PHONE NUMBER:
MELODIE JACKSON (907) 248-7000
PACE NUMBER:
2 OF 4
LEGAL DESCRIPTION:
SAND LAKE SUBDIVISION #2; LOT 4. BLOCK 6.
........
Profesikoo d,
TfPE OF WORK:
DESIGN FOR PROPOSED WELL CONECTION AND SEPTIC SYSTEM
AdvanTex Treatment System :�:-
AXSeries-Modela
One (1) 40x96 Pod
INLET
6" JIM CAP
--(TYP.2)
FINAL GRADE-\
6" PVC PUMP—OUT
(TYP.2) --�,
N
1500 GALLON
STEEL ADVANTEX
TANK
AX20 POD
NOTE: THE BOARD INSULATION TO BE
[STALLED OVER THE SEPTIC TANK & 4'
3EYOND ON ALL SIDES EXCEPT UNDER
HE ADVANTEX FILTER. THIS WILL ALLOW
FOR HEAT TO ESCAPE FROM TANK &
RISE TO THE FILTER ABOVE IT.
K
DISCHARGE
FILTRATE
10/01/2C
DRAWN BY:
R.A.L.
GARNESS ENGINEERING GROUP, Ltd. SCALE.*
S & GENERAL CONTRACTORS
3701 E. TUDOR ROAD. SUITE 101 - ANCHORAGE. " 99507 - PHONE (907)3374179 - FAX (907)358-SZ46 N.T.S.
IREPARED FOR: PHONE NUMBER: PACE NUMBER:
MELODIE JACKSON (907) 248-7000 3 OF 4
.EGAL DESCRIPTION:
SAND LAKE SUBDIVISION #2; LOT 4. BLOCK 6.
rYPE OF WORK:
PROFILE DRAWING OF PROPOSED 1500 GALLON ADVANTEX TANK
30 INCH
INSULATED
RISER--;
11
GIOTUBE
SCREENED
VAULT
EFFLUENT
PUMP
e fr
E 9
_30
---------------------------- I
-Fl. CID
2.5,
L----------------------------
1 15'-
GARNESS ENGINEERING GROUP� Ltd.
CONSULTANTS & GENERAL CONTRACTORS
704 IN TUDOq ROA� SUITO 101 m ANCm0R4GF AN 90507 0 ��F (007)3374170 - PAN 4007)331.3?46
REPARED FOR PHONE NUMBER:
MELODIE JACKSON 248-7000
DESCRIPTION:
.GAL
SAND LAKE SUBDIVISION #2; LOT 4 BLOCK 6,
rPE OF WORK:
PROFILE DRAWING OF NEW DRAINFIELD
GRADE
GRADE
FABRIC
10/01/2004
kwN BY:
R.A.L.
4
N.T.S.
...........
'E NUMBER:
4 OF 4
ffr
arness.:
—79 3
N r4
(0-�
PAP...... ..
GARNESS ENGINEERING GROUP, Ltd. 14
TANTS & GENERAL CONTRACTORS
ml L 101 0 Amook�L � "MY - �L (W7W7�ln - F�' (W7)= -M" .... . ..........
�LOG — PERCOLATION TEST
LEGAL DESCRIPTION: SAND LAKE SUBDIVISION 12; LOT 4. BLOCK 6, f G ness:
PERFORMED FOR: MELODIE JACKSON DATE: 9/g/2004
DEPTH p ........ .
(feet) rofe sl no\
ORGANCS ITEST HOLE #11
0-0 coo. c
00-0,-,0
970 006,6,0
ocpo.c
SW
006.0600
0-0 000p(
000 0 0,0
coo CPO* c
00-0000
12 — 00* 060"
000
14 —
15-00 a , Don't
00
'0000
17 O -a 000.,
,00 0.0-00-00%!(
3 00
0,0,0
18
DEPTH TO
GROUNDWATER
0 no 0
.0-06..
SOIL CLASSIFICATIONS
2 —
0 o DOC'
10/01/2004
GW ===. ORG
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DEPTH TO
GROUNDWATER
DATE
DRY
9/g/2004
DRY
10/01/2004
DATE READING
CLOCK NET TIME WATER LEVEL
TIME (MINUTES) READING
NET DROP
(INCHES)
9/10/2004
��W5
�c
�-�Lll-c)
9 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
:0 A FOUR HOUR PRESOAK WAS PERFORMED: E3YES ONO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN OSWALT
COMMENTS:
PERFORMED BY GEG, Ltd. 1. JEFFREY A. CARNESS. CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 10/01/2004
Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904 u n:s 4
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel J.D. 011-133-33 Expiration Date: Az- I L(
1. GENERAL INFORMATION
Complete legal description SAND LAKE S/D #2; BLOCK 6, LOT 4
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
8235 SEAVIEW STREET, ANCHORAGE, AK, 99502
DELLON SMITH
Day phone 260-7854
8235 SEAVIEW STREET, ANCHORAGE, AK, 99502
BERNARD POWELL WZ REMAX Day phone
Single Family (w/wo ADU)
Duplex
F-1 Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
360-2018
S H!
TYPE OF WASTEWATER DISPOSAL:
Individual Well
EJ
Individual On-site
0
Individual Water Storage
El
Individual Holding tank
El
Community Class C Well
Community On-site
Public Water System
Public Sewer
Received by: Date:
COSA to be released to the engineer, unless othenvise requested by the engineer.
COSAFee$ 4q()— d4Rq_l2_Q5k Waiver Fee $
Date of Payment I I I ali, Date of Payment
Receipt Number di Receipt Number
COSA # 0�rj ?) Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, i verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply andlor wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply andlor wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of ins(allation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
L
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE,
Engineers Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, GEG, UD. attempted be 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. 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 sawed by the system.
These conditions are outside the confrol of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
them 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 MQA 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 authorized, nor will it confer anylegal right whatsoever.
6. DSD SIGNATURE
X'_ System #1 Approved for bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
M
bedrooms.
99507
bedrooms, with the following
Phone
337-6179
Date k li-zc It 3
Original Certificate Date:
OF
�&t QITF- If-.) I-
VVA I F -1A
k WASTEWlIJER z:z
P:::�
The Municipality or Anchor6ge Developeint Services Division (DSD) issues Ceffificates of On -Site Systems Approval (COSA) based only
upon the represenatations, given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev. 11/05)
If more than I septic system is on the lot:
COSA Checklist # —of—
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: SAND LAKE S/D #2; BLOCK 6, LOT 4 Parcel ID: 011 - 133-33
rim 1111411 11111BY1 V4 r-11
Well typeCOMMUNI
Date completed —
Total depth —ft.
Date of test
Static water
If A, B, oroprovide PWSID#
Sanitary seal (Y/N)—
Cased to —ft.
FROM WELL LOG
ft.
9 -P.M.
Well Log (Y/N)
Wires properly protected 4�_
,_�Y
CasingJ �(above ground) —in.
AT INSPECTION
9 -p -m.
WATER SAMPLE RESULTS:
Coliform 0 GOlonles/100 ml. Nitrate 0-iOlb mg./L.
Arsenic: AL,_'bug./L. Date of sample: 11 /8/2013
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ADVANTEX/STEEL
Tank size 1500 gal. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping
Collected by: GEG, Ltd.
Date installed 7/30/2005
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
C. ABSORPTION FIELD DATA I*BELOW EXISTING GRAMI
Date installed 7/30/2005 Soil rating QEE�r ft2/bdrm) 3.0 System type TRENCH
Length 15 ft. Width 2.5 A Gravel below pipe 5.17 ft.
Total depth *9.3 ft. Eff. absorption area 155 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 11/8/2D13 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test DRY in. Wateradded 480 gal. New depth 1/2 in.
ElapsedTime: 10 min. Final fluid depth DRY in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN _ if yes, give date
D. LIFT STATION *SEE ATTACHED MAINTENANCE INSPECTION REPORT.
Date installed 7/30/2DO5 Size in gallons 150D Manhole/Access (Y/N)
YES
"Pump on" level at TIMER in. ,pump off, level atTIMER in. High water alarm level at in.
Datum BOTTOM OF BASKET Cycles tested Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent
Absorption field on lot On adjacent lots
Public sewer main
Sewer /septic service
manholelcleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+ —
Water main
10'+
Water service line ***JC)'+ Surface water 100,+
Wells on adjacent lots 100'+ PRIVATE/*100'+ PUBLIC
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line **11 + Building foundation 10,+ Water
10,+
Water service line ***l 0'+ Surface water 100,+ Driveway, parking/vehicle storage 10'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PRIVATE/*97'+ PUBLIC
F. COMMENTS
*PER ADEC WAIVER #5375. "PER MOA WAIVER #WRD40D77. ***PER CINDY ELLIS, P.E. AS–BUILT.
G. ENGINEER'S CERTIFICATION
I certify that / have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date it ) -20 ) / -?
(Rev. 11105)
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Municipality of Anchorage
Community Development Department
Development Services Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.munLorg/onsite
(907) 343-7904
Arsenic Advisor
Certificate of On -Site Systems Approval # OSC131610
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 6, Lot 4 of
Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration
of 81.8 micrograms per liter (ug/L) for the property's well water sample.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/L for public drinking water systems.
While private wells are not subject to this regulation, EPA standards are
based on existing health information and can therefore be used to gauge the
relative quality of water from private wells. information on arsenic is
available from the On -Site Water and Wastewater Program website
(��=.muni.org/onsite or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
S ' Systems Approval.
ite
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
��Day of /Uaue m L2e�� of 201 S, by and between &idA Frayttlgqg�l
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as
located at (legal description).
��d Z-.,. k e * D
2. Definitions.
Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts, components or pieces not
included in the original construction pen -nit and design.
Certificate of On -Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with Anchorage
Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that
the systems are adequate for the homes that they support and meet the
codes that were in place at the time of system construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included
in the original design which would allow the AWWTS to continue to
perform as designed.
Permit. An On -Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until the
property is sold or title is transferred by the owner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations, Installation and Removal of Additional Eguipment. Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
service and maintenance provider =roved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay
for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
6. Nonwaive The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such party thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with. and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement the only authorized representatives of the parties
are:
a. Owner:
b. Municipality: Director, Community Develoment or designated authority
C. Any attempt to amend, modify, or change this contract by either an unauthorized
representative or unauthorized means shall be void.
8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance
and Repair Agreement shall be brought in the Superior Court for the Third Judicial
District of the State of Alaska at Anchorage. The laws of the State of Alaska shall
govern the rights and obligations of the parties under this Maintenance and Repair
Agreement.
9. Severabil . Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OWNER:
By: Z � signature) Date:
L""§— (print name)
STATE OF ALASKA
)ss.
THIRD JUDICIAL DISTRICT
The foregoing instrument was acknowledged before me this I— day of
20JI, by -� 1�) -_jz�
Q,��z \-� \�4
NOTARY PJJBLIC R ALAS
My Conmumnission expires: _W �0 Q -N (Q
MUNICIPALIT :
By: 'signature)
Date:
name) Title:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 9951"650
www.muni.org/onsit6
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEms APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0/1- COSA# 10 007 4
1. GENERAL INFORMATION Expiration Date: G - 3 0 _/0
Complete legal description SAND LAKE #2; BLOCK 6. LOT 4
Location (site address) 8235 SEANAEW ST * ANCHORAGE, AK * 99502
Current Property owner(s) DELLON SMfTH Day phone 360-7854
Mailing address 8235 SEAMEW ST * ANCHORAGE, AK * 99502
Lending agency — Day phone
Mailing address
Real Estate Agent — Day phone
Mailing address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
El
Individual On-site
N
Individual Water Storage
El
Individual Holding tank
E]
Community Class—Well
N
Community On-site
El
Public Water System
0
Public Sewer
11
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems
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 samples. (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 certirted by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply andlor 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 rites and from my investigation and inspection, the
on-site water supply andlor 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 CARNESS ENGINEERING GROUP,
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 lost, and separation
distances measured to readily Identirtablo 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 otthe 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 authorized, nor will it confer any legal right whatsoever.
5. IDSD SIGNATURE
Approved for —2— bedrooms.
Disapproved.
F;1 I = Z'
337-6179
Date Shq/10
0011111 "A21F
wl� A
Conditional approval for — bedrooms, with the fliowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
PENN
Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Report
Other
OF
ON-SITE
rn:.
WATER AND
WASTEWATER
PROGRAM
9K�
By: azl�� �3-30-10
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
0
Legal De . scription: SAND LAKE #2; BLOCK 6, LOT 4 Parcel ID:0 �11._ 1 -9-3 _3 -3
A. WELL DATA ]COMMUNITY WELL]
Well type CLASS C If A, B, or C provide PWSID# Well Log (Y/N)
Date completed
Total depth —ft.
Date of test
Sanitary seal (Y/N)— Wires properly
Cased to —ft.
FROM WELL LOG
AT INSPECTION
ground) —in.
static water level
Wefffr'oduction —9 -P.M. 9 -p -m -
WATER SAMPLE RESULTS:
colonies/100 ml. Nitrate Q_J_mg.1L. Other bacteria -colonies/100 ml.
Coliform 0 C
Arsenic: Ill. 3 ug./L. Date of sample: -3/12/2010 Collectedby : GEG Ltd.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material ADVANTEX/STEEL Date Installe 1 d 7/30/2005
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
i
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A
Date of pumping 2//0A'C>10 Pumper
C. ABSORPTION FIELD DATA F -BELOW EXISTING GRADEJ
Date installed 7/30/2005 Soil rating 0—pd/�')or ft/bdrm) 3.0 System type TRENCH
Length 15 ft. Width 2.5 ft. Gravel below pipe ft.
Total depth 9.41 ft. Eff. absorption area 155 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 3/12/2010 Results (Pass/Fail) PASS For 3 bedrooms.
Fluid de r pth in absorption field before test 0 In. Water added 650 gal. New depth 3 In.
Elapsed.Time: 5 min. - Final fluid depth 0 in. Absorption r I ate 450+ g.p-d-
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN — I f y es, give date — —
D. LIFT STATION
Date Installed— Size in gallons— Manhole/Access (Y/N)
"Pump on" level at—in. "Pumpoff"Ievel High water alarm level at in.
Cycles tested— Meets alarm & circuit requirementsl
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer /septic service
areas
On adjacent
On adjacent lots
manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field. 5 +
Water main 10'+ Water service line ***10'+ Surface water i 00-�
Wells on adjacent lots 100'+ PRIVATE/*100'+ PUBLIC
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
i I
Property line **Jl+ Building foundation 10'+ Water main 10'+
10'+ 100'+ 2'+
Water service line - Surface water Driveway, parking/vehicle storage
Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PRIVATE/*97'+ PUBLIC
F. COMMENTS *ADEC WAIVERS IN PLACE. SEE ATrACHEI). "WAIVER EXISTING, #WR040077
***PER CINDY ELLIS, P.E. AS—BUILT DWG.
OF A
G. ENGINEER*S CERTIFICATION ..........
I certify that I have determined through field inspections and ;�-' . . *' - Y* Vol
..... . ..........
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date. J r Gor ess.-*
*P
Engineers Printed Name JEFFREY A. GARNESS 0 —7 3
2
Date to
e5910(lo
COSA Fee S 14 C7 0 Waiver Fee $
Date of Payment 1C.) Date of Payment
Receipt Number Receipt Number
(Rev. 11105)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.orglonsite
(907) 343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # 100074
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 6, Lot 4 of
Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration
of 14.3 micrograms per liter (ug/L) for the property's well water sample.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/L for public drinking water systems.
While private wells are not subject to this regulation, EPA standards are
based on existing health information and can therefore be used to gauge the
relative quality of water from private wells. information on arsenic is
available from the On -Site Water and Wastewater Program website
(www.muni.org/onsit )or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
08/11/2009 08:34 8686770 APLUS PAGE 03
144396
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Nollon
AnchorageTank &Welding, Ina
907-272-3543
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(907) 6=41149
8235 Seaview street Anchoritge AK 99502
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11/1912008
AX -105826
SWD40441
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Dapyflow�
A�bcrww—
'Farn"wilmw
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04W of SOMP40
TYPICW DMisly Sfwthy 0100MY
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onythnimpyu CIWO NO
Founa In bwk Ovot No
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Realm Amps owda" Aff"
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Dial"reftele schgonm
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ln$Pfd C"n
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fbm .......................
rwv .......................
VMbe FIft . ............
BWhfb6 PUMP VQLdt .......
Ftechv.daflng SOMerVeNe .......
14, r I
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measure SludoolSom
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TYPICW DMisly Sfwthy 0100MY
N�wi-w Owwo 19cabbeAp 0D --Y
onythnimpyu CIWO NO
Founa In bwk Ovot No
Check Contmi Panel
Realm Amps owda" Aff"
ALKW* und w1mul Ww
Dial"reftele schgonm
in2p*WCI*an Pump System
ln$Pfd C"n
FU�AA ..............
SP1100 BOX .............
r1out ccwdm ...................
fbm .......................
rwv .......................
VMbe FIft . ............
BWhfb6 PUMP VQLdt .......
Ftechv.daflng SOMerVeNe .......
14, r I
Comments I 1h 6 alwir; ZIA
measure SludoolSom
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Curn-vt
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Most oords 0
inapect/Sarvi" Other System Compo"ift
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Impect
uwaismom 0
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