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SAND LAKE #2 BLK 2 LT 16
and Lake 2 Block 2 Lot 16 #011 � 133�09 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM Ali WELLINSPECTION REPORT PermitNumber: YU-105-il PID Number: Ott - /_9-3 -V,9 Name: 1`t1Cj4&e1 Ple-r-tietr ke 'r — Wastewater System: El New M Upgrade Address: 6 t L4,-" I i X 99si ABSORPTION FIELD Phone. Number of Seciroorns `cb Z 6S- 9 6" 3 V Deep Trench 0 Shelf. Trearch 0 Bad 11 M..ed 0 Other LEGAL DESCRIPTION Soil Rating Total Depth from original grade: GPD/Fi? 0 Ft. Blool, Let Subdivision. 2 16 S, a ke # Depth to pipe bottom from original grads: vat d Grai depth harreath pipe 15'- 0 Ft. -7. 6 FL T.vini Range: Section Fill added be. i grade: 's "g, Gravel Length 1.0 Ft. 'Y Z Ft. Well: iF,4s III` El New Ej Upgrade Gravel ,idth Numbs oi "am. Dist.m.11viveen lines, 2, 2 .57 Ft. Ft, Classification (Private, A, B, C): Total Depth: Cased to Total absorption area: Pipe Material D -30 3 V t� -6ed Ft. -Bar. Ft in 588 W Dnili Drilled. Static Water Level: Installer tDt, InsIed., Ft :� -7 JOS— Pump Set at: Yield Casing Height Above Ground GPMJ Ft. Ft TANK SEPARATION DISTANCES Ei Septic El Holding El S.T.E.P. El Other: Septic Absorption Lift Holding — ;ublhVPmvade _Fan�.A -� �psc,, Tank Field Station Tank Sevvt�rl_ine Aric�Aot-!!�7e 7-,:;,, /to' Material: — Number of Compartments. '2 >I C� > le� LIFT STATION S -W-nefe=,, Lot Line 10 X Gal. Foundation 7FUMP -W _I -Val at in. r mp off' le,,.1 at in High water alarm st. in, Curtain Drain Pump Make & Model Electrical Inspections performed by: Remarks. BENCH MARK _r ee lk A:, nAz 12��peoll r e -&-r Aetoe 1� /3jr Ar�tse Fl. 16 4 Engineers Stamp N�, Inspections performed by: ii 7_-ec4,i,m/!�-e_Dates: let 7/ It nd -7 2 if Development Services Department Approval THi F. AMAO�O/RE.-- Reviewed and approved by� Date: CE-3589 Rev 12100) _7 14 PERMIT NO: SWO50166 PID NO: 011-133-09 NEW 1000 -GAL - SEP. TANK SWING TIES: FROM: COR. "A" COR. "B" TO: S.T. C.O. "C" 40' "1 s.T. C.O. "D" 42.5' 43.5' DEL. C.O. "E" 43.5' 43' VALVE 7" "1 43' TR. C.O. "G" 47' 33' TR. M.T. "H" 46.5' 34' TR. M.T. "1" 32' 45.5' TR. C.O. "J" 31.5' 45.61 INLET INV. 92.31 NEW 42 -FOOT LONG TRENCH W. 7.0' EFFECTIVE GRAVEL T W B \�7T.H. t R 100' PLAN VIEW SCALE: I" = 30' OUTLET INV. 92.0" INV. 91.8 42 -FOOT LONG SOIL ABS. TRENCH w. 7.0'EFF. GRAVEL BOTTOM TRENCH ELEV. 84.8'-j CROSS-SECTION SCALE: I" = 5' BOTTOM T.H. #1 ELEV. 77.8' M.T. DRY 611 110 ORIGINAL GROUND ELEV. 97.8' LOT 16 BLOCK 2 WELL T NW ............ THEODORE V MOORE WASTE LINE FROM HOUSE LOT 16, BLOCK 2, SAND LAKE #2 SEPTIC SYSTEM UPGRADE AS -BUILT INSPECTION REPORT FLATTOP TECHNICAL SERVICES SCALE AS NOTED 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 JULY,2005 MUNICIPALITY OF ANCHORAGE 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 Upgrade Date Issued: Jun 06, 2005 Expiration Date: Jun 06, 2006 Permit Number: SW050166 Parcel ID: 011-133-09 Legal Description: SAND LAKE #2 BLK 2 LT 16 Design Engineer: 0019 Flattop Technical Services Site Address: 008124 WILCOX ST Owner Name: MICHAEL MCCLASKEY Lot Size: 6750 SQ. FT. Owner Address: 8124 WILCOX ST Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 995024152 This permit Is for the construction of: 2] Disposal Field E Septic Tank Holding Tank E] 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: Ta� wu�� Date: I=: 161 erl evality ofAlichorage 82(X) P.O. 1k, RX&O a Anchomgc, Alaska!XX5519-66N) 0 Telephone ((.X)7)343-934)1 - ha (!X)7) W. 47(X) 11mgaw Strcct 9 Anchomgc, Alaska 99507 "IV, " .... 11.Org Mayor Mark Begich 13tilldirld SafCtV I)IOS1011 L, - June 6, 2005 Ted Moore, P.E. nattop Technical Services 14530 Echo Street Anchorage, AK 99577 Subject: Waiver Request for Sand Lake #2 Block 2 Lot 16 Waiver Request WR#: 050038 Parcel ID # 011-133-09 SWO50166 Dear Ted Moore, P.E.: Your request for a waiver of the required 10 feet horizontal separation from the absorptionfield to property line has been approved. The approved separation distance is 1.0 feet. Ibis 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 arc any fiirther concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, ro Goodall Goo vil Engineer .1 v1 ite V n -Site Water & Wastewater Program C0111111111lity, Secutity, Prosperity Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: 050038 PIDN: 0 11-133-09 HAIPermit# SWO50166 Date Received: June 6, 2005 Legal Description: Sand Lake #2 Block 2 Lot 16 Engineer Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, AK 99577 Applicant: Michael McClaskey Waiver Requested: I Foot Lot Line Waiver to North or South Property I-Ine Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver Is Granted: X Waiver Is not Granted., List Conditions or Reasons for above: Date: W6/05 By: Joe Goodall Name of Reviewer Rec#: 68658 Amount: $176 Date Paid: 6/6/2005 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 PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Off - 1'47-09 Permit Number SW A I T Property owner(s) Kc c-4 41 t K c C laz 1-c ;X Day phone, cl, 2d-4- - 91c.., Mailing address 49MY 14-OIICOA Cl- Zip Code 9 1 ro 1. Site address $1 7-Y kv I I cc, V rA Zip Code Legal description (Lot, Block & Sub'd.) I.Cly, Jr, .61&Ck Z, _'CaAV1 40ke #Z Legal description (Section, Township & Range) Lot Size —Acre /Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 3 Sewer Only 13 Well Only El Sewer and Well 1:1 Water Storage E3 Sewer Upgrade R THIS PROPERTY CONTAINS: Hot Tub Jacuzzi 11 Swimming Pool Water Softening Unit El Therapy Pool 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 with applicable Municipal Codes. V'_e� x., ';'� (Signature of property owner or authorized agent) Permit/Rush Fees: 6-C., Waiver Fees: '7� I -C /C Date of Payment: 0,�, Date of Payment: C/1 lor Receipt Number: eceipt Number: 69 (Rev. 09/04) ,,,FL���ATTOP"T-E%f-";-"""NICAL-- SER ICES_-_� MU & ENIVIRONIMENTAL ENGINEERLNG - ENERGY CONSERVA710N &NALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. P11: (907) 345-1355 ANCHORAGE, AIASKA 99516 May 30,2005 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: Ile purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 16, Block 2, Sand Lake S/D #2, located at 8124 Wilcox Street in Sand Lake. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. We arc also requesting a lot line waiver allowing the trench to be constructed as close as I foot from the north or south property line, and also for the new septic tank to possibly be as close as 3 feet from the original soil absorption trench which can potentially be reused. The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil log, the native material below 3.75 feet is a silty sand with a measured perc rate of 5 minutes per inch. Using a slightly conservative soil application rate of 0.8 gpd/sq. ft., this 3-bedroorn residence requires a total absorption area of (3 x 150)/0.8 = 563 square feet. The proposed 42 -foot long trench design with an effective gravel depth of 7 feet has a total absorption area of 588 square feet. Due to the small size of the lots in this subdivision there is very little room available for constructing the septic upgrade outside the 100 -foot radius surrounding this lot's private well. In preparing this design we have endeavored to maximize the utilization of the remaining space, because further upgrades will be very difficult to construct. Granting the requested lot-linewaiver will have little impact on the ability to construct future upgrades on the adjoining lots because the proposed trench is perpendicular to the lot lines meaning that it has a relatively minor shadowing effect on the developable areas across the lot line. Both lots 15 and 17 also have slightly more area' available for septic upgrades than Lot 16. A similar lot line waiver was issued in 2002 for the existing trench, which will be kept in reserve. We propose to install the new septic tank between the new and the existing trenches ht a location 5 feet from the new trench, which may cause it to be as close as 3 feet from the existing trench. No significant adverse impact due to this configuration is anticipated. 1he topography of the lot in the area of proposed construction slopes gently downwards towards the west at approximately 3%. Except as discussed above, the proposed project will have nb significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. L8. B2 SEPTIC AREA ABANDON EXISTING SEPTIC TA L9. B2 INSTALL NEW 1 000 -GALLON SEPTIC TA INST. "BULL, RUN" VALV�E SEPTIC AREA RELOCATE SHE AS NECESSARY 1-10. 82 SEPTIC AREA % PVT. WELL LOT 15 BLOCK2 % % % 1% % % , I c; 9F A 4 Ar -vo LOT 16, BLOCK 2. SAND LAKE SID #2 SEPTIC SYSTEM UPGRADE 49 nml SITE PLAN ..... ....... .... ... FLATTOP TECHNICAL SERVICES I INCH 30 FEET THEODORE F. MOORE 0 14530 ECHO STREET DRAWN BY TFM CE - 3589 .0-* ANCHORAGE. ALASKA "516 MAY, 2305 �,�,Af 0. Ar --- Nk�t0fe,s%00 40' NOTE: THIS IS NOT A SURVEYED PLAT. 10;00W ALL LOCATIONS SHOWN ARE APPROXIMATE. 0 0 SEPTIC AREA 400= 00-05'500005: 0 0�0 ui 0 0 T - -j CONSTRUCT NEW 42 -FOOT LONG TRENCH .7.0'GRAVEL BI CLASS WELL LOT 16 BLOCK 2 RIW % PVT. WELL LOT 15 BLOCK2 % % % 1% % % , I c; 9F A 4 Ar -vo LOT 16, BLOCK 2. SAND LAKE SID #2 SEPTIC SYSTEM UPGRADE 49 nml SITE PLAN ..... ....... .... ... FLATTOP TECHNICAL SERVICES I INCH 30 FEET THEODORE F. MOORE 0 14530 ECHO STREET DRAWN BY TFM CE - 3589 .0-* ANCHORAGE. ALASKA "516 MAY, 2305 �,�,Af 0. Ar --- Nk�t0fe,s%00 40' NOTE: THIS IS NOT A SURVEYED PLAT. 10;00W ALL LOCATIONS SHOWN ARE APPROXIMATE. INSTALL NEW 1000,GALLON--\ SEPTIC TANK lox, DOUBLE TO EXISTING TRENCH INSTALL "BULL RUN' DIV. VALVE C.O. EXISTING ASTM F-810 PERF. PIPE 4- DIA. PLAN VIEW "A" D-3034 SCALE: Igo 10, 14 w ..... ... TtAtODOR�- F. A40ORE UT _T or �LEAN0 MOU I NO BACKF LL 6" 0 �M.T. CONSTRUCT NEW 42 -FOOT LONG SOIL ABSORPTION TRENCH w. 7.0 FEET GRAVEL UNDER DIST. PIPE ASTM F-810 PERF. PIPE 13 7.5 1 7 CROSS-SECTION "A"_"A" SCALE: III = 5, IGINAL GROUND TER FABRIC WASTE LINE 4"DiA. F-810 PERF. PIPE FROM HOUSE 112* - 21/2"SEWER GRAVEL BOTTOM OF EXCAVATION LOT 16, BLOCK 2, SAND LAKE #2 S/D SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS St IOWN 14530 ECI 10 STREET DRAWN BY: ITM ANCIIORAGE.AY�99516 MAY, 2005 PLAN VIEW SCALE: Igo 10, 14 MN R E 0 'To TUB ..... ... TtAtODOR�- F. A40ORE UT .6—k& or �LEAN0 MOU I NO BACKF LL 6" 13 7.5 1 7 CROSS-SECTION "A"_"A" SCALE: III = 5, IGINAL GROUND TER FABRIC WASTE LINE 4"DiA. F-810 PERF. PIPE FROM HOUSE 112* - 21/2"SEWER GRAVEL BOTTOM OF EXCAVATION LOT 16, BLOCK 2, SAND LAKE #2 S/D SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS St IOWN 14530 ECI 10 STREET DRAWN BY: ITM ANCIIORAGE.AY�99516 MAY, 2005 FLATTOP TECHNICAL SEWCES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 SOILS LOG — PERCOLATION TEST LEGAL DESCRIPTION: I ot IS RIW* 7 Sand I Ake SID 02 DATE PERFORMED: ny 25 7005 PERFORMED FOR: Nipf Th mnq CnIdwell Ranker - Fnrtj ine PL I SLOPE --- 1 SM Silty sandy fill material PL Original topsoil SM Reddish sandy loam SM Gray silty sand SofL easy digging "chunky" below 17 damp @ 18' B.H. 0% 0%. Depth to Groundwater I Date *1 -etw OTM .... .. ... .THEODORE V MOORE CL -25S9 SITE PLAN w Sell 3% Date Reading Clock Net Tom Time (minutes) Peroometer Net Drcp Reading (inc)es) 5r25 _12" Prpqaak ___27 M — _jZLResqak 9Z-3/8- - 11,21 233/8 11,31 10 20L!�VJO— 2 PL16 — Add ter 11-31-50 _-23_&B__ 21 9 3ffi— ;g2 Add er L15– 23 ia_ *3 ft52*15 10 211/8 2 &a— PERCOLATION RATE__.5_ (minutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEN 7.5 FT AND__B.D__ FT PERFORMED BY FLATTOP TECHNICAL SERVICES. I '�� *2'fO-� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6,111cis- (FfAttop Technicarsen*es 14S30 Echo Street, Rnchorage, AX 99516 Thont (90 7) 345-135S Lot 16, Block 2, Sand Lake S/D #2 8124 Wilcox Street Wastewater disposal system installation Specifications 1.0 General: 1.1 'Me scope of the project consists of abandoning an existing septic tank and installing anew 1000 -gallon septic tank that discharges effluent into a new 42 -foot long soil absorption trench containing a total of 7.5 feet of sewer gravel. It should be pointed out that the only feasible access to the construction area is via a 10 -foot wide space along the south side of the house. This will necessitate careful maneuvering to avoid damage to the house. It should be possible to temporarily remove the terminus of a wooden fence on the side of the house to gain a little more room, provided it is replaced and the gate reassembled upon completion of the work. L' 2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. A lot line waiver has been requested down to I foot; it will probably be necessary to dig the trench inward from both ends, necessitating the fabrication of a temporary barrier in the middle to prevent the sewer gravel in the first portion from sloughing while tile second portion of the trench is being excavated. 1.3 'Me contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 Unless agreed otherwise, the contractor shall be responsible for any tree clearing and grubbing necessary to complete the project. Prior to the start of excavation, the contractor shall cut down and remove the branches of all trees larger than 6 inches in diameter and neatly stack these trees outside the construction area. If requested by the property owner, the contractor shall then bury non -detrimental branches, brush and roots generated by the construction work at a suitable site on the property located no less than 10 feet away from all present and foreseeable construction areas. The contractor shall neatly stockpile any detrimental material which cannot be buried, for subsequent disposal by the property owner. 1.5 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.6 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank must be properly abandoned by thoroughly pumping, carefully extracting, crushing, disinfecting with bleach and burial in a suitable location on site. 2.2 The new I 000 -gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil at the designated location between the existing and new trenches. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed immediately upstream of the 90 -degree ell preceding the tank, and a double cleanout shall be installed within 5 feet downstream of the septic tank. A "Bull Run" diverter valve shall be installed downstream of the double cleanout allowing future reconnection to the original trench. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 42 -foot long trench to a depth of 13 feet below ground level. Please note that it will probably be necessary to dig the trench inward from both ends. To do this will necessitate the fabrication of a temporary barrier in the middle of the trench to prevent the sewer gravel in the first portion from sloughing while the second portion of the trench is being excavated. 3.2 Ile bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Since the new trench will cross the site of the site of the original septic tank, the hole from its excavation will need to be backfilled with native sandy soil prior to trench excavation. 3.3 A total of 7.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts arc no less than 7.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. -The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the new property owner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backf ill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ?k ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchnrage, Alaska 99501 Telentinne 264A720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE if-4�Ew M"077 IAtl OUPGRADE MAILING ADDIIIESS SIT x "d Aze 9f eo LEGAL DESCRIPTION /, LOCATION NO. OF BEDROOMS DISTANCETO: Wall /os Absorption f a Dwelling PERMIT NO.il. M 7r 2 Manufacturer Material No. of compartments Ul< Liq. capacity in gallons I f5no IF HOMEMMADE: Inside length Width Liquiddepth DISTANCE TO: Well 1 Dwelling 1 PERMIT NO. z Manufacturer Material Liquid capacity in gallons a -lx DISTANCE TO: ' Wall Foundau Nearest lot line PERMIT NO. L" /,?,2 U —;Wz No. of lines Mt.l.t.finishar. Length of ta� Total length of ines Trenche�dlh Distance between lines z W P;iz Top, de J11 Matterial beneath tile Total effecti,ra r on area P 94, Inch .1 Width Depth PERNit I NU. ul Crib diameter Crib depth Total effecti,ni absorption area Well Building foundation Nearest lot fine Class Depth Driller Dista RMIT NO. L DISTANCE TO: Building foundation Samar line Septic tank Absorption area(s) OTHER PIPE MATERIALS 1.1 Pvc J fiftitf-akci $01 L TES INSTALLER REMARKS M)NIC a rth 0. Talbot f rjM )NN OF ENTAL AE�4H PfrIV "iiulr 11416% Ile APPROVED DATE LEGAL rn ;q CA fD ::s tF Lqq D i 0 0 0 0 0 0 0 0 0 0 0 0 0 c luj !CD io I CC) G�, 0 6n 0 0 0 0 0 0 i to C� 0 i 0 �o co !,A -tr f�- :%A 1-.3 0\ C7 I 0\ :W 0 1 co i o" o :10 i 0 m co m :w m ;O;Onpl m �.j �-j tP �+Mic+WOPtM 0 k+Hj 1-- ;3 0: H im .4 N1.4 it4 c+: C+ C6 I! C+ s M jrA jV cl I ro clo EO �D s i .44 -oc+c+. tc+ FJ" :C.d C:11., i M (D I CD M I H! H FJ H I m 06 10 C+ (D C4 X 0 2 0 0 0 0 2 2 x k: 9 �4 �,o !-j 1 CN !�3 i iA 0 0 0 t.A 0 LM I" !-I rI M -En M�NICIjAL17j OF �N&ORAbf t "I" 1 03 rwm A.A., Z) 4 < r+M M ffo- tj C+ . . . RLCEIV-VD fc+ -:ck C'+ Fj oa :00 I t-4 PC 10 p. C+ ; ? I LI) 20 to 1" to En jP� CL 10 DD r -I o ic) N a o 0 :9. < Z FJ 0 i3 (D .4 (D F, I M 0 r r 0 M > > rn tv rA > ! oa :00 I t-4 PC 10 p. C+ ; ? I LI) 20 to 1" to En jP� CL 10 DD r -I o ic) N a o 0 :9. < Z FJ 0 i3 (D .4 (D F, I M 0 r r 0 M mu"lclf�nL_l_ry c3F= nNc"oF?.noa DEPARTMENT V�-N HEALTH AND ENVIRONMENTAL r'ZOTECTION 4 825 'L STREET, ANCHORAGE� AK. 95 -�l 264-4720 j4[=-j_L_ nr-JE> C)r4--�=l-rE=- �-.M-14F-EFZ F�'E=_F;zr'll_r_ PEPMIT NO. ( S10793 ) iPPLICANT TOM WESTERHOF SRA BOX L146 99507 349-5367 OCATION WILCOX EGAL . L16 82 SAND LAKE LOT SIZE 6750 SQUARE FEET YPE OF SOIL ABSORPTION SYSTEM IS: TRENCH AXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 150 HE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: >E:F='-r"= :JL2: L_FZN0-rH= 0FZnVaL_ E>E:F�*YH :a THE LENGTH DIMENSION IS THE LENGTH (IN FEET� OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A 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 DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). Zl-=iMU3:FZE:r> 'S5EF:1=3'-rlC -rFRr-4K �L0010 13F=jL_L_0r-4� =_RMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE 4STALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY FIND THE JMBER OF RESIDENCES THAT THE WELL WILL SERVE. -r 1.4 0 < ��Z > 3:PsI:SFz�E:C::-rlC3r-JE; F:IF:;*E-= FRE:G�UlF.l-=l:)' ICKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS -PARTMENT WILL BE SUBJECT TO PROSECUTION. INIMUM DISTANCE BETWEE14 A 14ELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 30 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC 14ELL DEPENDING DON THE TYPE OF PUBLIC I -JELL. ENIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND ) A COMMUNITY SEWER LINE 15 75 FEET. ELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS : THE WELL COMPLETION. rHER REQUIREME14TS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE iAILABLE TO INSURE PROPER INSTALLATION. f�F-=Fz.::Mj-r a:.�<f=,jFZas_r-- E>FE0FEPlE�>FEF;Z :I_ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS FOP ON-SITE SEWERS AND WELLS AS SET )RTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE'SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE 'SIDENCE IS REMODELED TO INCLUDE ORE THAN 3 BEDROOMS. :GNED:- '/'� dl- ------------ APPLICANT TOM WESTER�� �V4. 0 :SUED BY-- ---------- 2�A.44_!� - ----- DATE__2 X- SOILS CdG MUNICIPALITY OF ANCfi'&k4,W,9 ANCHORAGE . ' n.. t ' T'J !� DEPARTMENT OF HEALTH AND ENVIROMWENTALPROTECTION.4 0 PERCOLATION 825 L. Street, Anchorage, Alaska 09501 2"-4720 TEST ' 1, Al SOILS LOG -PERCOLATION IrEvt 2 5 1962 RECEIVED PERFORMED FOR: A Fn4pr DATE PERFORMED: L2 LEGAL DESCRIPTION: 6ev'"d -JOL 14 1 2 3 4 5 6 7 10 11 12 13 14- 15. 16- 17- 18. Is- 20 - 2.1 � IM o 511+/Lorrs M) -eklh) 0/(� P) Silfp'L J , 7ere bo graM d WAS GROUND WATER ENCOUNTERED? No SL 0 P IF YES, AT WHAT E DEPTH? I+ SITE Reading Date Gross Time Not Time Depth to Water Net Drop PERCOLATION RATE_ TEST RUN BETWEEN PERFORMED BY. ca�;i CERTIFIED 72-008 (6/79) (minutes/inch) — FT f MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L. Street. Anchorage, Alaska 99501 264-4720 TEST SOILS LOG - PERCOLATION TEST PfRFORMEDFOR: 'nKA g�E-Irl DATE PERFORMED:- 7 LEGAL DESCRIPTION:— LOA- lien LasAt"Z 5k%bLjL(.0M so%. r.DEPTHI SLOPE SITE PLAN 2- 4- 6 7- 8.1 910. j %so SF lop WASGROUNDWATER S ENCOUNTERED? L u 12 P IFYES,ATWHAT E 13 DEPTH? 14- Date Gross Time 15- Depth to Water Net Drop 16. 17- 18- ;P, 19- 20 ";;re. 1*6*'f*o*' NO. 199" Reading Date Gross Time Net Time Depth to Water Net Drop s, 101L S-01, -4— It LPERCOLATION RATE 2 (minutelfinch) TEST RUN BETWEEN rT AND FT COMMENTS PERFORMED BY: c Na EAJiC IA2E&a S CERTIFIED BYJWt� ;n%Ce_(e_p OATE:7-7-4-6-1 A ccwtp. 72-006 16/79) Municipality of Anchorage MEMORANDUM DATE: October 9, 1981 TO: Laura Crow FROM: Senior office As'sistant Sewer and Water Program SUBJECT: Request for Refund - Account 02460 please make arrangements for the following refund, a private engineer inspect&d the installation of the on-sitc sewer system rather than this office. TOM Westerhof (Westerhof Construction) Star Route A Box 2146 Anchorage'r Alaska 99507 Legal Description: Lot 15 Block 2 Sand Lake Subdivision #2 Lot 16 Block 2 Sand Lake Subdivision #2 Receipt # 155100 Amount: $60-00 Laura J. Ward Senjor.OffiCe Assistant IzW attachments Tirre Time a Date Date Date Inspector Inspector rFiFe�ctor� Comments t" WA�Z Conditional Approval 1180*1001MI]Q11 visspproved EUAporovc:d Date Sewer installed Permit No. Septic Tank Size (Doo Holding Tank Size Solis Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT. LOWERHALF ONLY.. Property Owner ll'h'� 6:�'e3. jo Phone l4alling Address 1� 5" 21w :Buyer CVee 40 e 7/e Address Lending Institution /rj,, Phone Address Realty Co. & Agent Aj- Phone Address of Legal Description A( zez' '104 Street Location 0"le-0) ie ?V, TypeAt Residence Single Family 0 Multiple Family No. of Bedrooms (I Other Wat r Supply 1; Individual ATTACH WELL LOG. A well log Is required for all wells drilled since June • Commurill 1975. For wells drIlled prior to that date, give well depth (attach log It • Public Utllrty available.) Sewbe, 01sposal ndlyldual Year Individual Install U Public Utility When Connected to Public Utility: 0 Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED. rebruary 8, 1982 Thomas A. Westerhof SRA 2146 Anchorage, AK Subjectt Lot 16, Block 2. Sand Lake #2 Dear Mr. Westerhof; Approval for the individual sewer and water facilities cannot be granted until the following items have been completedt The depression or pit around the well casing needs to be filled with impervious type soil so that it slopes away from the well casing. The water sample could not be taken due to silt content (turbidity). The well should be flushed clear by turning on a garden hose until clear water is evident over an extended period of time* Please contact this department for a resampling appointment. Please notify this department for a reinspection when the noted discrepancies have been corrected* If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt Ascociate Environmental Specialist 4)�D V4�� _ of . Development Services Department _� p p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 011-133-09 Legal description SAND LAKE #2 BLK Site address 8124 Wilcox St Anchorage 2 LT 16 Current property owner(s) Thomas and Grace Cool Expiration Date: Id Zo Z 3 x The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 2/10/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE z n Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section -- Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 011-133-09 Complete legal description Sand Lake #2 Block 2 Lot 16 Location (site address) 8124 Wilcox St. Anchorage, AK Current property owner(s) Thomas & Grace Cool 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: © Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 6. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 18 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed © Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5.5_0 Date of Payment g �q /,Z(IA3 COSA# (SSC a31()aq O�— 030%( ? Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 Legal Description: Sand Lake #2 Block 2 Lot 16 Parcel ID: 011-133-09 If more than 7 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ✓❑ Well log is filed with Onsite (or attached) Date drilled 12/22/81 Total death 510 ft Cased to 510 ft Wl Sanitary seal is functioning correctly k?] Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 1/30/23 Static water level at beginning of test 97 ft Comments B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 3/18/22 ❑ Required maintenance completed, ifAWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/11/05 F/1 ALL standpipes present per record drawing Total measured depth from grade 13 ft (max) Measured depth to pipe invert from grade 6 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑✓ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Com ments/Deficiencies: COSA Checklist June 2022 Well production at time of test 4.5 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes Q No Z Coliform bacteria is Negative Nitrate mg/L ✓❑ Nitrate less than MRL (ND) Arsenic ug/L ❑✓ Arsenic less than MRL (N D) Collected by Arcterra Consulting Date 1/30/23 T STATION ❑ Require tenance completed Age of lift station s Lift station material Comments: Adequacy test date 1/30/23 Results Q Pass Fluid depth prior to test 48 in Water added 450 gal New fluid depth 58 in Elapsed time 960 min Final Fluid depth 48 in Absorption rate 450-+- god FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 84 in Effective depth used 48 in Effective depth remaining 36 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' Yes if No ft ✓❑ Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' P1 Yes if No ft Holding Tank > 100' Z Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' © Yes if No ft Q Yes if No It ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' R Yes if No ft Surface Water > 100' Q Yes if No ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS *Waiver #050038 ❑ Yes if No ft ❑ Yes if No 1* ft ✓❑ Yes if No ft R Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' © Yes if No ft © Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Areterra Consulting Phone (907)=6f96-6111 Engineer's Printed Name Kenneth Duffus Date �4125, 5 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. COSA Checklist June 2022 S c,f 9 V cA" Municipality of Anchorage On-Site Water and Wastewater Program . cid III (907) 343-7904 SAF ETY Certificate of On-Site Systems Approval Parcel I.D. 011-133-09 Expiration Date: 9 ` 1 " (7 1. GENERAL INFORMATION Complete legal description Sand Lake #2, Block 2, Lot 16 Location (site address) 8124 Wilcox St. Current Property owner(s) Racette, Angela Day phone Mailing address 8124 Wilcox St. Anchorage, AK 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received b / i �� �.0 Date: £ /L// COSA to be released to the engineer, unless erwise reques d y the engineer. COSA Fee $ - r2 Waiver Fee $ Date of Payment 5-- 3 / "' ( 7 Date of Payment Receipt Number 7 / 2 Receipt Number COSA# ©_S C-- / 7 (2-Q 2- Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe 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 soil condition,ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 5/30/2017 pec OF'��Askl 6. DSD SIGNATURE System #1 Approved for 3 bedrooms / • Steven .'I3onnone . r CE-8149 System #2 Approved for bedrooms s . % Disapprovedkkl OFESSIONP '~- trrt`��� Conditional approval for bedrooms, with the following stipulations: , �`�4, at rtiTyc/)G 3" 0I.1_SI-CE G�, WA-cERAA ER c wASTEW PROGRAM 'A rr (r r-- rr By: t - ( .4 l� Original Certificate Date: / -(7 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory �C Well Flow Advisory Other COSA blue sheer E If more than 1 septic system is on the lot: COSA Checklist# 1 of I Structure served by this system " Certificate of On-Site Systems Approval Checklist Legal Description. Sand Lake #2, Block 2, Lot 16 Parcel ID: 011-133-09 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 12/22/1981 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 510 ft. Cased to 510 ft Casing height (above ground) 12+ in FROM WELL LOG AT INSPECTION Date of test 12/22/1981 5/19/2017 Static water level 132 ft102 ft. Well production 50 gpm 4.5 g p m WATER SAMPLE RESULTS: Coliform t V colonies/100 mL Nitrate ND mg/L Arsenic In, 9 ug/L Date of sample: 6111 i t Collected by: WS B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date instal ed�k-Fl9 -9-114)CS Tank size 1 '000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 10/14/2016 Pumper One Stop Pumping C. ABSORPTIO FIELD DATA, L} Date installed D°°n+� } ratingSoif� DeTrench (g.p.d./ft2 or ft2/bdrm) 0.8 GPD/SF System type Length 42 ft. Width 2.5 ft. Gravel below pipe 7 ft Total depth 13 ft Eff. absorption area 588 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/1 9/2017 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 66 in Water added 466 gal. New depth 73 in. Elapsed Time: 1440 min Final fluid depth 66 in. Absorption rate >= 450+ g p.d. No Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 1* Building foundation 10+ Water main 0+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *WR# 050038 ** As-Built on File G. ENGINEER'S CERTIFICATION 4� OF 4 I certify that I have determined through field inspections and rg'�••..• t#� review of Municipal records that the above systems are in f*;• 4 :14i\ V conformance with MOA COSA guidelines in effect on this date. •1�• Engineer's Printed Name Steven R. Pannone f�� •' ;Sle''. NI •one. • e 5/30/2017 +#� CE-8149ilt Date ���'' '• COSA brown sheet 10-10-12.doc • •� Municipality of Anchorage r k _ Development Services Department s j Building Safety Division SA ET1 On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # OSC 171202 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 16 of Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration of 19.9 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/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. Parcel I.D. 011-133-09 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Gretchen StulleF 1. GENERAL INFORMATION Expiration Date: q - q 0 - 1_5� Complete legal description Sand Lake #2, Block 2, Lot 16 Location (site address) 8124 Wilcox St. Current Property owner(s) Ronald Reinhardt & Brandi Trout Day phone Mailing address 8124 Wilcox St. Anchorage, AK 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) F1 Duplex Fl Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual Fx_1 Individual Water Storage El Holding Tank El Community Class Well 0 Community El Public Water System F-1 Public Sewer F� Waiven/Variance request Received by: \AAA4AA""_ Date: J /1,D1201 5 COSA to be released to the engpler, unless otherwise requested by the engineer. COSA Fee $ 57,( p Waiver Fee $ Date of Payment 111(-1115 Date of Payment Receipt Number otl3q,)G Receipt Number COSA# 0 05-1006 Waiver * 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my sea[ affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments, Therefore we Cannot provide any warranty for future performance, nor can we estimate remaining life of the system, The content of this report is for the sale benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Date 1/13/2014 N or - V'. A0,*. TH ... ... . ...... W. annona CE -8149 lu Conditional approval for bedrooms, with the following stipulations: By 1A Original Certificate Date: T a r, Calit, of A, h un �pall��o Aa0brage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Ajaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheM � - ., c If more than 1 septic system is on the lot: COSA Checklist# 1 of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Sand Lake #2, Block 2, Lot 16 � �11 RAffuu-11 Well type Private If A, B, or C provide PWSID # Date completed 12/22/1981 Sanitary seal (Y/N) Y Total depth 510 ft. Cased to 510 ft. FROM WELL LOG Date of test 12/22/1981 Static water level 132 Well production 50 ft. g.p.m. Parcel ID: 011-133-09 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 12+ in. AT INSPECTION 1/6/2015 101 4.7 9 -p -m - WATER SAMPLE RESULTS: Coliform OG(r colonies/100mL Nitrate mg/L Arsenic "—.5 ug/L Date of sample: 01 -5 Collected by: ecs B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed Unknown Tanksize 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Date of pumping 1/7/2015 C. ABSORPTION FIELD DATA Date installed Unknown Soil rating (g.p.d ./ft2 or ft2 /bdrm) 0'8 GPD/SF System type Deep Trench Length 42 ft. Width 2.5 ft. Gravel below pipe 7 Total depth 13 ft. Eff. absorption area 588 ft 2 Monitoring tube Y Depression over field N 1/6/2015 Pnzc 1 Depression over tank (YIN) N High water alarm (Y/N) N Pumper A+ Home Services ft. Date of adequacy test Results (Pass/Fail) For — bedrooms Fluid depth in absorption field before test in. Water added 466 gal. New depth 22 in. Elapsed Time: 200 min. Final fluid depth 1 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No 0 if yes, give date Date installed "Pump on" level at in. "Pump off"Ievel at Datum E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ Manhole/Access (Y/N) Hk*-w ,ater alarm level at Meets alarm & circuit On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holdingtank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Watermain 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 1 * Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *WR# 050038 ** As -Built on File G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 1/13/2015 COSA brown sheet-10-10-12.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ in. 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.muni.org/onsite (907) 343-7904 Arsenic Advisor Certificate of On -Site Systems Approval # 151006 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 16 of Sand Land #2 Subdivision. This inspection revealed an arsenic concentration of 26.3 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/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. -7 117 1) /A < 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.d.anchorage.akus (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAmiLy DWELLING Parcel I.D. 0 11 - 13 3 -e:p3p HAA#__Q-f3_D_3_:234 Expiration Date: 0 - 0 E� 1. GENERAL INFORMATION Complete legal description I -of 16, 61c, I C4c-2_S-re,)e1 4rl-ce t*? Location (site address or directions) Ot?_y 4c,,1Cr'A SY CurrentPropertyowner(s) fieckcof mc jo�jcv �-, ;X_ Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 812- y be 1'1c�-X Ell AA C 4k 9,9 Z 7;7 9se _ tueltr. F—Czc "PQ — Day phone N10( — -0� 7k4Ae r Day phone __ 2&5- 7 10Z z Unless otherwise requested, HAA will be held by DSD forpickup. Pjpa ' .le CCAII 7&"el Ada'"_r 2. NUMBER OF BEDROOMS: -3 '2v�S'-91V_3 oo-H�VI-SW23S' 4,uA.#, "A ;j rok�e�( C-(*.(, 7/Z// '0 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWAT-5ER DISPOSAL: Individual Well 0 Individual On-site M Individual Water Storage 11 Individual Holding tank El Community Class Well 11 Community on-site 0 Public Water System 13 Public Sewer 171 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil 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 tesults. (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. 0A 1"I 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 files and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of Installation. NameofFirm rlabLa4 -O�Lf<r Phone 3tT- 1:LZF_ Address 116'30 acAo Anc4c;�-2��. Atc 9 5,16, Engineer's Printed Name r. J-ec,0-e_ Date V'O" 491V * S. DSD SIGNATURE V. __1z Approved for. bedrooms. THEODOM. F. MOORE J Cc.35s? ;J7, Disapproved. Conditional approval for bedrooms, with the following stipulationgn,,�.'_11' Attachments: HAA Checklist X Septic System Advisory . Well Flow Advisory Maintenance Agreements Supplemental Engineers Report Other By: /)"�z Original Certificate Date: 0 - as - 7W 45�1 (R. 01102� 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.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: tof tlr 6bg1e^20 QI)a 441<0 -�/042 Parcel ID: 011-133-09 A. WELL DATA Well type _-ELI I If A. B, or C provide PWSID # _.AL.4. Date completed J!_JZZ/,6/ Sanitary seal (YIN) --h Total depth _JL49 ft. Cased to ff �Oft. FROM WELL LOG Date of test 1%. 1 2- -Z. / 0 1 Static water level 13 z ft. Well production 9 -P.M. WATER SAMPLE RESULTS: Coliform 0 olonies/1 00 ml. Arsenic: mg./I. B. SEPTIC/HOLDING TANK DATA Nitrate .40.1 - mg./I. Well Log (Y/N) Y Wires properly protected (Y/N) Casing height (above ground) /.r n. AT INSPECTION 'Y /S- / zcfos�- 107 ft. 9 -P.M. Other bacteria S colonies/100 ml. Date of sample: !�/ 23lo-c Collected by: �=Ic4ko� 7--c4 -f-c Tank Type/Material S&P hc_ / r �-ee I Date installed -7 / 1Y / 0_'S7 Tanksize 100 gal. Number of Compartments 2 Cleanouts (YIN) Irl Foundation cleanout (Y/N) Y Depression over tank (Y/N) V High water alarm (Y/N) P. 4 Dateofpumping N.A. (nLcAJN Pumper ty. A C. ABSORPTION FIELD DATA Date installed.M/ I V 1,0S- Soil rating (g.p.d./ft? or ft2tbdrm) _" 74 el System type 7-;- ell c4 Length �1 Z ft. Width — 2-S ft. Gravel below pipe -7. t-� ft, Total depth 13,0 ft. Eff. absorption area 5S6 fe Monitoring tube Y Depression over field V Date of adequacy test N.A. (nrw) Results (PaWFail) Pe4-r For 3 bedrooms Fluid depth in absorption field before test 6 in. Water added 0 gal. New depth_j,,�2_ in. Elapsed Time: — min. Final fluid depth 0 in. Absorption rate >= IYS'o g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N — If yes, give date MA D. LIFT STATION A. Date installed — 'Pump on" level at_ in. Datum Size in gallons 'Pump off" level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1/0, Absorption field on lot 10,01 — Public sewer main M -A Sewer /septic service line > Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots it of 6090 '1/0/0 On adjacent lots Public sewer manholelcleanout V. A Holding tank V - * - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation '38' Property line 140' Absorption field Water main A. Water service line '> 10 Surfacewater Wells on adjacent lots /00*+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line " IWIROS003& Building foundation 30' Water main V- 4 Uorl.71,01- ) Water Service line -> tpl Surfacewater �> lexo, Driveway. parking/vehicle storage �), q'o Curtaindrain AlaAe 5'e0e) Wells on adjacent lots -LO-0 I+ F. COMMENTS HAA Fee $ Date of Payment Receipt Number (Rev. 12/01) Waiver Fee S Date of Payment Receipt Number G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in 49 TH' 1W conformance with MOA HAA guidelines in effect on this date. %THEODORE F. ALOORE Engineer's Printed Name 7-Agl�gt6--d i= Date HAA Fee $ Date of Payment Receipt Number (Rev. 12/01) Waiver Fee S Date of Payment Receipt Number 0 ui w th co rn WILCOX STREET 100.0s 3.ts,co.o s 0 > > z u L -C UX '4 b 13 Uio 4 Z b Uio Z 0 in too z LL ,00-0s M.ts,co.o N Municipality of Anchorage -0 Development Services Department it Building Safety Division 181:;�i On-Sitia Water & Wastewater Program C>& 4700 South Bragaw St P.O. Box 196650 Anchorage. AK 99SI 9-6650 www.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 011-133-09 HAA# HA020346q 1. GENERAL INFORMATION Expiration Date: 0 'P_ Complete legal description SAND LAKE 12 LOT 16, BLOCK 2 Location (site address or directions) 8124 WILCOX STREET Current Property owneqs) LAWRENCE EVERETT Dayphene 338-5089 Mailing address 8124 WILCOX STREET, ANCHORACE ALASKA, 99502 Lending agency Day phone Mailing address Real Estate Agent JOHN LEVY Day p hone 251-7520 Mailing address DYNAMIC PROPERTIES 3111 "C" STREET ANCHORACE. AK 99503 Unless otherwise requested, HAA w771 be held by DSD forplickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL' Individual Well W Individual On-site Individual Water Storage 0 Individual Holding tank Community Class—Wen 13 Community On-site Public Water System 13 Public Sewer 0 The Municipality of Anchorage Development Services Department (DSO) 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-slte Wastewater disposal andlor water supply system. DSO also Issues HAAs upon request to homeowners. Certificrites 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 samples. (Certilicates maybe reissued for a _p�nod of up to one year with valid water samples.) Certificates are valid for one year for properties 30rved L# Class A or 0 wells or a public water Isystem. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engrneer3 wnrk Note: Alaska Water and Wastewater Consultants, Inc. shag be paid S at orprior to dosing for Me engineering servkes provided. I 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of (he vagda lion 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 andlor wastewater disposal system Is(ore) safe, functional and adequate for the number of bedrooms and 4W of a tructure Indicated herein. I turther verify that based on the Information obtained from the Municipality of Anchorage riles and from my Investigation and Inspedion. the on-affe water suppfy andlor wastewater disposal system ls(are) In compliance with off applicable Municipal and State codes, ordinances. and regulations In effect at the Vme ofinstaffation. Name of Film . ALASKAMATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 . I Address 6901 DESARR ROAD. SUITE 28 0 ANCHORAGE. AK 99504 Engineer'3PrInted Name JEFFREY A. CARNESS, P.E. Date 7 fx Engineeft Comments: In conducting this evaluation. AKV$WQ Ina attempted topmvide a thorough, conscientious ongifteating analysis of Me system In accordance Wth ADEC and MCA OF DSD Guidelines & Regulations. The reported results described the performance 01`978 system under the conditions encountered of the Ume of Me test. and separation % distances measured to readity identifiable features. The operational fire of 09 "Its and septic syslems depend on the kcal soft condition. gmundwatedevels Mat may . . ........ t ... Iftectuate during Me year. and the water usage of the family being served by the systern These concutfons we outside the control of Me evaluator of the system. Satisfactory lost ....... results do not guarantee ruture performance offhe system, not do they guarantee that r(y ormess.- them are no hidden defects or encroachments. AXVv= Inc can therefore not provide CE -7953 any warranty orAiture estimate of how long the System w0tCWVnue to meet me ......... * ". operational requimments of Me ADEC or MCIA DS0. The content of this report Is for . r'd% the sote benefit of the cwnerfisted above. Any reliance upon or use ofthIs report by any S4 otherpemart orparly Is not authorized. nor wfl; 9 conterany legal tight whatsoever. S. DSD SIGNATURE L#***f Approved for bedrooms. Disapproved. Conditional approval for — bedrooms, with the flowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory M3nitenance Agreements Supplemental Engineer's Reort Other 0 ATER AND ATER G M W N By: 10 0 Original Certificate Date: 9 - 2 - 0 a- Municipality of Anchorage Development Services Department eukift zesty Division 4700 South Bragaw St. P.O. S= IN= kIchange, AK M194M ww*xLan&mgeAkA* 343-711" HEALTH AUTHORITY APPROVAL CHECKLIST Legal De=lption: SAND LAKE 02 LIS. BLOCK 2 Parcela 011-133-1 A. WELL DATA Wel type PRtLA3 If A, 6, or C provtda PWSID# N/A Well Log (Y/N) YES Deb cornplatedi 12/22/81 Sanitary seal (YIN) YES Wires property protected (YIN) YE Toteldepth 510 ft. CasedID 400+ FL Casing height (abom ground) 120, FROM WELL LOG AT INSPECTION Date of test 12/22/81 5/28/02 Soft water level 132 fL 120 won prodtbwon 50 g-p-rn. 8.0+ g-p.rn. WATER SAMPLE RESULTS: Collform 0 colonfeW1100 rd. Nitrate !MnVJL Dow WOW% 0 colonliwil Arsenic: 0.02 rng,IL. Date of IlaMpta: 5/28/2002 Clollected by: AKWWC, INC. B. SEPTIMOLDING TANK DATA Tank TypelMatertal STEEL Date Walled 8/28/81 T*nksi= 1000 get. Nwiber of Cornpartrnents 2 Cleenouts (YIN) YES Foundation d=nM (YIN) YES Depression war lank (YIN) NO High water alarm (YIN) N/A 01111601purnpirIg 5/17/2002 Purnper CHUGACH PUMPING j C. ABSORPTION FIELD DATA I -mow FOUL CR" Date Installed 5/2 0/81 Sao rating (gpAAVO!E�N -150 Sohn type TRENCH Length 31 It. WkM 2.5 ft. Gmvel below pipe a Total depth I? ft. Eff. absorption wen 496 ft' Mw*oft Um *YES Depes3ion ova field Date of adepamy Iasi 5/31/02 Results (ftssW*V) PASS For 2 bedr Fkdd depth In abmption field belm test DRY in. WSW SW000463gal. New depth 85 Elapsed Tkne-, I I 10 min. Final JIM depth 29 In. Absorption rate 300 Any re)rvenatlon beatrnerIt (post 12 rno.) (YIN & type) NONE ]KNOWN If yes. give date - 5 0. LIFT STATION Date installed Size in Gaff" Uanhole/Acco" (Yfl4) -Pump on- level at —in. 7ump ofr k---1 at-Lx—ln. High WBW alarm IMI at Datum Cycle3lesw Meets alarm & circuit requirements?_ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO. Septic tanIUM an lot lOO'* On adjacen W 0950 Absorption Bald an lot 100'+ On adjacent kft 195, Public sewer main N/A Public sew mardtole/cleanout N/A Sewer /septic service Kne 250+ Holding tank N/A SEPARATION DISTANCES FROM SEPTCHOLDING TANK ON LOT TO: BddbVftmftkn 5-+ Property Nna 5,+ Absorption fleld Water main N/A Water service line 10,+ Suftce wrater too*+ 100'+ Web an adjacent W SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: PrWerty One 01. Building tundabon 10*+ Water Malin N/A Water service the 10*+ Surface water 11000+ Driveway. parkhowme wrap 10!-4 Curtain drain NONE KNOW Wells an a*cent lots 100'+ F. COMMENTS *WAIVER REOUEST ATTACHED 0. ENGINEER'S CERTIFICATION I oe0y that I hm detem*wd through gold kMNKV= and review of Uunk*Wrecofts that ft above systems are In corftmance with MOA HAA g4da&ex In eftd on M daft I Name D to -1,00P =70� -174, JEFFREY A. GARNESS HAA Fee $ M5 Datecipayrrrient 7`51""0Z Receipt Number 235.5(0 PW.12M) W" Fee S 11VA Daft of Payment 7--:31,wOZ RacelplNumber 2353(0 Jul 01 02 01:36p MOORE M 9073385089 p.2 OF 11 .r A � 9 9,;49TH Of of �1 ; Dames Korl 'Dowling Aw NjMTHIS ASBUILT IS NOT TO BE USED FOR ANY SUBMITTAL TO THE MUNICIPALITY OF ANCHORAGE. It is the. responsibility of the owner to determine lite �• existence of any casements, covenants or restrictions which do not appear on the recorded subdivision plat. EASEMENTS OC RECORD, OTFIERfiHAN THOSE Under: no cireunutanccs should any data $ereon be truclion or for establishing boundary or ASBUILT SHOWN ON THE RECORDED PrLAT.,ARL• NOT'.. . usedtfor cons Sl{OWN HEREON. fence lines. The surveyor takes responsibility for tinet:FNR: initial tmnsaction only-' BRASS CAP MONUMENT O IRON PIPE LOTSBLOCK (PLAT NO.: �� • R>rBAR CORNER FOUND ❑ HUD AND TACK ' ANCHORAGE RECORDING DISTRICT PREPAVD BY: ASSOCIATES DOWLING & z 1426 Hyder. Street. DATE BY Anchorage, Alaska 99501 REVISIONS FIELD BOOK: GRID NO.: BY: SCALE: WORK ORDER: lei � Y Z�Z ti 8/l/2002 Jefrrey A. Gamess, PE Alaska Water & Wastewater Consultarits, Inc. 690t Debarr Road. Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Sand Lake #2 Subdivision Block 2 Lot 16 Waiver Request #WRO20056 Parcel ID #011.133-09 On -Site Systems Approval Number HAO20369 Dear Mr. Gamcss: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing absorption field to property line separadon only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this departmenL If there am any Eirther concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program 0 CILP Muni a1W of Anchorage .1drAmommummil�. at -'l -b -me �4-0 George P. Tuerch. Mayor Deports kv.� Public Difflding Safety Diiisior, 0 P.O. Box 19MM 0 4700 S. Dragaw Strcct Anchorage, Alaska 99510-6650 9 MM 343-&301 bttp://%%,%-w.cianclioragc.o)Lus 8/l/2002 Jefrrey A. Gamess, PE Alaska Water & Wastewater Consultarits, Inc. 690t Debarr Road. Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Sand Lake #2 Subdivision Block 2 Lot 16 Waiver Request #WRO20056 Parcel ID #011.133-09 On -Site Systems Approval Number HAO20369 Dear Mr. Gamcss: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing absorption field to property line separadon only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this departmenL If there am any Eirther concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program wAivsx RE17LAEir Smvv1,os&w Mock ZJ-or Wfiivr;)c iftevesr WHOJER WROZO .Sg:p.rjc PAT7?— E -. -. ritp. tv n s re wg rEpt i le; rEof cov L v r lo— tu.4 x c- c*Ao r ric s, c rzp iov V" Is rp.*A., i*ERcvi.*7,x Ar A fflArc oF lextIVAUCAe C4jffjtpjr.)2 .4.7 AAP lov POW rue J�J4�rmw*rcx rr;rem /S Locarso 41rt,'rRj4ojgrAor Piro." TWE WAN it E 0M. r,�\ W61.1 &74rA— Ttjr_ tv$TCR WrIl 1Al4urrjr14V 11 5'/o Ferr p4FXpVjejL4So IN PU. /fe/ Tme AvAll- Cp6r /Nofro?ry Srve'r*l. jokoruep'lele -.<Ywoqr* c Lq ov (At v 0 cnmv 6 tv 0 t4,vp i-Mer,4 cl- ? tvye jet " r,* Iq r" 10104'r tp 77If. AA-elPtAt Ar 4ff FtEr 4w&&/.x 7-YAf 1-r repvc.,04. O -P 7,q4e LAKe- 4filEA. FOIATS t-I&L 01 C&COUVrO rV MAr PIRXT 0.06,05 CA &, ,n r 3 Ffo rEsr. 7*14E fro4rie_ &—*rr.1 lrvet. raoorit /2o"rie .4 6-R OUAIO Avel"Ce. WArVK S4MPLIr REX94L.77 IAIPICMrP- NP "Cr"14 -VAW WO #VITK'4 w E.. C. 5. A W. 6-. Oro., rN W4rEiT Prom jrrirem of ae CIS 4,:r .-P, I ? pl)� ;v" � 6, 2 + /97 L it) W.Mlz MaLe HaRizvNrpt. SEMxqncA.- - -25 � 13,11. ettAICI-JeflOAl _ Ov-AlAlr IA.41VEJe r -N t-n.#A,PV rOM. e. / ::F. ?. 2,3 ALASICA WATER F-7- WASTEWATER CQNSULTANTS, INC. - July 26,2002 Municipality of Anchorage Development Service Department Building Sarety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-665D Ref: Lot Line Walver for Lot 16, Block 2 Sand Lake Subdivision H2. To whom it may concern: We request that your department issue a I foot lot line waiver from the south property line to the existing drainficid. I am unawarc of any adverse impacts this waiverwould have on adjacent wells or stplic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistancc./l/ SJ clyl ty JA s, E., M.S. A U'l Pr en. Z& 6901 Debarr Road, Suite 2B 0 Anchorage, AK%V6� .0 A ALASKA WATER WASTEWATER CONSULTANTS, INC. 1 July24,2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 9951 M650 Ref: Waiver Request and Health Authority Approval for Sand Lake SID #2 Lot 16, Block 2. To whorn it may concern: Ile existing 3-bedroorn house is served by a private well and septic system. We request you grant a 9S foot separation distance waiver from the well on the referenced property to the septic tank and drainfield on Lot 15, Block 2, Sand Lake SID 92. The well that serves the subject property was drilled on December 22, 1981, and the septic system on Lot 15, Block 2 was installed on September 7,1990. The following items are justification for the waivers: • The subject well Is located uphill from the septic system, so it is impossible for surfacing effluent to migrate towards the well head. 11c only path for contamination would be subsurface. • Recent water sample results (copy attached) indicated nitrate levels to be 0298 and coliform bacteria results to be 0. In short, the water quality has not been adversely impacted, even after 12 years of encroachment. • 7be location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. • Attached is a number of drilling logs for wells in the general vicinity. The groundwater is confined at a depth bclow215 feet in all of the wells. It can be seen in virtually every log that there arc numerous layers of either till, claylgravel, hardpan, or other confining geological profiles. Clearly, based upon the current water quality, these layers have served to protect the aquifer. Based upon the aforementioned facts, it appears that there Is minimal risk associated with the 95 - foot separation distance waiver. rom rii,"� vn,A In * A"A^rinA AV QQVU The well that serves the subject property was drilled on December 22. 1981, and the septic system that serves Lot 15, Block 2, Sand Lake SID #2 was installed on September 7, 1990. It is our understanding that the property owner of Lot 15, Block 2; Sand Lake S/D N2 is responsible for the waiver foes. We also request that your department issue a I lealth Authority Approval. If you have any quAitions, please contact us at 337-6179. Thank you for your assistance. M.S. 6901 Debarr Road, Suite 2H * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 0 Website: akwwc.com oil jL .4" .I;. : 10 1 RE=Eo Js LOT 17. CLOCK 2 SAND LAKE S/D 12 EXISTING THREE BEDROOM HOUSE LOT 15. BLOCK 2 SAND LAKE S/D 12 LOT 14. BLOCK 2 SAND LAKE 5/0 12 DATI c - 40, 7i I" WN 0. 1 w w ORA ATASI�ANIFAI'l-"It&NN'ASIT4,NlrNI'ER $CA CONSULTAMS. INC. At PREPARED FOR: PHDNE NUMBER: PAC LAWRENCE EVERETT (907) 338-5089 LEGAL VESCRIPTION: SAND LAKE f2: LOT 16. BLOCK 2 TYPE Of WORW SITE PLAN