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HomeMy WebLinkAboutSAND LAKE #2 BLK 7 LT 7and Lake #2 Block 7 Lot 7 #011-132-30 Municipality of Anchorage (_ Development Services Department Building Safety Division - On -Site Water and Wastewater Program, 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 Page ( of Z www.ci anchorage ak.us (907) 347-79D4 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP lO / CJ/ S PID Number: 0l I - LIZ - a0 Nama 1 --rel 0 L D"r-jgee Wastewater System: ❑ New ® Upgrade Address 8309 A-elory<oo ABSORPTION FIELD Ph a ._I y ) ZG7 - X759 NLmaer Y Bedraxna 3 0 Deep TnW 0 ow nShallTmnrlt 0 Bed 0 Mowll C3 Other LEGAL DESCRIPTION Sal Rabng TOW Depth eom onginal prat GPDd i• FI. Bio,k Lot SuD Von Depth W ppe button horn ong,nal grade Gravel depth M am ppe' % S0'7e,! I^. # Z Fl. FI Townsap Range sachon FA Wand Wove OnpnY pada Gravel LWVM. FI. Ft. Well: CxrST ❑New Upgrade Gravel vnd1h: Numelr Of Wee Onunu heol'eM WH FI. FI Claspheaaon (Pnvale. A, B. C) Total Depth caud to TOW aasapaon arra Pip1 Matenr. Ft. I Ft FIt U - 3z,:; Dmbr Date Dn1Md Staac Walw Level Nstan•[ At- No~ St -c. Dais Nelaked. I 6 /3/2o/O Ft Yield PuWSeUi "Man"'-o'.N TANK GPM FI. Fl SEPARATION DISTANCES 19 septic ❑ Holding ❑ S.T.E.P. ❑ Other. To From Septic Tank Absorption Field Litt Station Holding Tank lublicrPmate Sewer Line aciww A'I Ca o fel %lin L- •pooh /opo Get wen 96e IMienr SfPPi1 NutMel Y compartments 2 sudadlwata,)lost LIFT STATION I1/.,} Lot Lne i t J/� II Gal atlW! 'PLOP on. NvY at 'Pump ow IIW Y High voter Nam at FWMItiM N'(y N N N Putty Make 6 Model Elaptncal Nsp•caons ped~ by Cunrn one. Ranks Orr rn�el 1 �,o iunl T, Oma, BENCHMARK •ePa. Loudon ell Drnm u �PCrrm cvALI;eegee✓ /' lcY c4v, / 13! JVJFV.F Oii id'n f`'•m t N C WIM IlvaaM r3��ucrC1 Crafton oAukinCv Co�na: of /Fr aa/ IOp•(J FL Engineer's Stamp Inspections performed by: 1= Int fc4 T�e-A Svc. Dates: 1' ! �3C zv/n nd ouott <'re' (QC Development Services Department Approval •^� •• '••; a! Conditional Approval Date: ; 's;'';�4914L �......a.........•.....t.» TUMORE F. hh"t . �1 < CE - 3569 r •.�P4r Reviewed and approved by: // Date: -/ 7 -11-) ...... � R, 01006) :, J!'t ,. , , ,a.. PERMIT NO: OSP101018 PID NO: 011-132-30 3.6 SOIL COVER �-2" RIGID INS. PAGE 2OF2 NEW 1000 -GALLON SEPTIC TANK N R_ •C• CAR PORT EXISTING I R' r. REE Ous LOT 7 BLOCK 7 PLAN VIEW �••������ SCALE: 1" = 30' s`�~E.�.At1f��� *4V 49 DI s •t� 1 ......................... ......s. . 7.744e—tri ♦ ♦ THEODORE F. MOORE i ,l s. 4KIlloe six 4w lww INV._/V - !EXISTING TRENCH NEW 1000 GALLON PERFORATED PIPE D4.8'SEPTIC TANK 6' "—NEW MONITOR TUBE PROFILE VIEW NOT TO SCALE LOT 6 SWING TIES: _ WELL FROM: COR. "A" COR. "B" TO: I.- w DRIVE DBL. C.O. "C" 12' 33' Ix S.T. C.O. "D" 4T 59.5' rn S.T. C.O. "E" 53.5' 63' o DBL. C.O. "F" 60' 6T L) M.T. "G" 61.5' 67' ss WELL 3.6 SOIL COVER �-2" RIGID INS. PAGE 2OF2 NEW 1000 -GALLON SEPTIC TANK N R_ •C• CAR PORT EXISTING I R' r. REE Ous LOT 7 BLOCK 7 PLAN VIEW �••������ SCALE: 1" = 30' s`�~E.�.At1f��� *4V 49 DI s •t� 1 ......................... ......s. . 7.744e—tri ♦ ♦ THEODORE F. MOORE i ,l s. 4KIlloe six 4w lww INV._/V - !EXISTING TRENCH NEW 1000 GALLON PERFORATED PIPE D4.8'SEPTIC TANK 6' "—NEW MONITOR TUBE PROFILE VIEW NOT TO SCALE On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 / Telephone: (907) 343-7904 6 3 Permit Number: OSP101018 Tax Code Number: 01113230000 Work Type: Septic Upgrade Permit Effective Dates: May 19, 2010 to May 19, 2011 Design Engineer: FLATTOP TECHNICAL SERVICES Subdivision: SAND LAKE #2 Site Legal Address: SAND LAKE #2 BLK 7 LT 7 G:2224 Owner/Address: DURFEE SHERI KAY 8309 WILCOX STREET ANCHORAGE AK 995024162 Site Mailing Address: 8309 WILCOX ST, Anchorage Lot Size In Sq Ft: 6750 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage ent 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by tatting (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either. A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: t Municipality of Ancho P.O. Box 196650 • 4700 Elmore Road Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http:f1www.munLorg1Onslte Development Services Department On -Site Water and Wastewater Program menr h l epartment **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP101034 COSA#: Permit#; OSP101018 PID#: 011-13230 Legal Description: Sand Lake #2. Block 7 Lot 7 Engineer: Flattop Technical Services Applicant Frank Durfee Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 2.0 feet. Your request for a waiver of the required 10 feet horizontal separation from the septic tank to the property line has been approved. The approved separation distance is 3.0 feet. Your request for a waiver of the required 100 feet horizontal separation from the septic tank on Sand Lake 42, Block 7 Lot 7 to the private wells on lot 7 and Sand Lake #2, Block 7 Lot 6 has been approved. The approved separation distance is 90 feet and 83 feet respectively. In 1986 the location of the tank on lot 7 was approved. This new tank will increase the separation from wells to tank that was approved at that time. The current nitrate level for the Lot 7 well is .144 mg/L. This waiver approval applies to the existing absorption field and proposed tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Approved by: AA Name of Review ............................................................................... Rec#: 131419 Amount: $1,050.00 Date Paid: 5110110 Municipality of Anchorage Development Services Department _ Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING OS'1�IOtOIi� Parcel I.D. Oil — 13 —3io Property owner(s) F;nn^t- Dct.'r 0e Day phone &1 `U 7u7 — Ir _7S-9 Mailing address r20 S- ► r,l1 llftlft�, 0/ -,,Plan Tx Zip Code 'f t 07c - Site address 6— 3 C, 9 Wt leo x S><. A -*i c Avg ez�Z e Zip Code 9950-2 Legal description (Sub'd., Block & Lot) l o F 7., g /oc t, 7, Se -in-,( l c, lcr tt? Legal description (Township, Range & Section) Lot Size 67�V Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank a Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial ❑ Upgrade IR Renewal ❑ 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. a �5r 9716—� (Signature of property owner or authorized agent) Permit/Rush Fees: �'3 G" Waiver Fees: 16S-0 Date of Payment: 5� / (i / 10 Date of Payment: Receipt Number. t" Li 1 Receipt Number. (Rev. 11/05) :FLATTOP TECHNICAL SERVICES CML & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS TED MOORE, P.E. PHJFAX:(907)345-1355 E -Mail: tgmoore@gci.net M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: May 9, 2010 14530 ECHO CANYON ROAD ANCHORAGE, AK 99516 The purpose of this letter is to provide the required design narrative in support of our application for a permit to replace a failing septic tank on Lot 7, Block 7, Sand Lake S/D #2, located at 8309 Wilcox Street. A site plan, plan and cross-section and specifications as well as a current as -built property survey are enclosed for your review. In order to make this possible, we are also requesting issuance of a waiver allowing the new tank to be located as close as 90 feet from the private well on the subject lot and 83 feet from the private well on Lot 6, Block 7, and as close as 3 feet from the north property line. These well separation distances are greater than those achieved by the present failing septic tank, and during construction we will endeavor to achieve slightly greater distances wherever possible. Due to the extremely small lot sizes in this subdivision, waivers have been requested and issued in the past to allow many of the wells and septic systems to be installed and approved. There are numerous examples of prior Municipal waiver analysis evaluations in your files for this and nearby lots. Fortunately, the wells arc generally over 400 feet deep and the aquifer supplying the drinking water is confined by an impermeable clay stratum. To assist you in your waiver evaluation process I am enclosing driller's logs for the wells on Lots 7 and 8, Block 7 which I extracted from your files. There is no driller's log on file for the well on Lot 6, however it is located only 50 feet north of the well on lot 7, so the driller's log for the lot 7 well should also apply to the well on lot 6. Water samples collected last November from the residence on Lot 7 showed no coliform or other bacteria and an almost undetectable nitrate level of 0.144 mg/I; both of these indicate the absence of any septic contamination of the aquifer. The water sample test results did show a relatively high arsenic level of 72 micrograms per liter, but that is from a source unrelated to septic systems. New water samples will need to be collected and tested for bacteria and nitrates to allow COSA issuance prior to the scheduled sale of this property in June. Based on the enclosed well data, absence of existing septic contamination, and the fact that the new tank will be located further from wells than the existing tank, I believe the requested waivers can be granted without concern as to adverse impacts on public health. In fact, the elimination of a very old steel tank that is quite possibly leaking and replacement with a new, freshly coated tank located further from the wells should improve the water quality situation. The waiver request for the tank to be as close as 3 feet from the north property line is to allow some flexibility in the positioning of the tank on this very constricted lot. It is quite possible that we will in fact be able to achieve the normally required 5 -foot separation, and we will endeavor to do so, however a 3 -foot separation would not adversely affect the ability to construct future upgrades to the Lot 6 wastewater system. The waiver request to allow the soil absorption trench to be as close as 2 feet from the east property line is simply to reflect the existing situation, and will not have any further effect on the ability to develop soil absorption systems on adjoining lots. The trench was originally approved as being 8 feet from the property line, but 1 can only assume that people were only considering the location of the ends with respect to the north and south property lines and failed to realize that the side of the trench is actually significantly closer to the east property line. Please feel free to give me a call if you have any questions on this submittal. Sincerely, Ted Moore, P.E. T SEPTIC SYST. e LOT 19 LOT 18 (VACANT) LOT 17 SEPTIC_ SYST. OF 49 ................... THEODORE F. MOORS ., CE-35�F;i �c� 0"V', ., ei ofesslo��� �xw,Z%, :s LOT 19 SEPTICt AREA Ir. — INSTALL NEW cAx 1000 -GALLON SEPTIC TANK `*MAU NEW M.T. w TRENCH ;LOT 18 �E RETAIN `••.(VACANT) TRENCH — SEPTIC AREA LOT 17 LOT 7, BLOCK 7, SAND LAKE #2 SEPTIC TANK REPLACEMENT SfTE PLAN FLATTOPTECIINICALSERVICFS 11NCH=40 FEET 14530 ECHO CANYON ROAD DRAWN BY TFM ANCHORAGE, ALASKA 99516 _ MAY, 2010 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. LOT 5 (VACANT) LOT 6 HOUSE SEPTIC SYSTEM WELL ................._ �''., i _-•• O ED rr. � T Q I L DRIVE cAR roRr HE EXISTING oEeorrtasioM BDRM EIIanNG REf HOUSE SEP TK TAN K LOT 7 WEu BLOCK 7 1 fes' HOUSE ' LOT 8 WELL SEPTIC _ SYSTEM i' 49 ................... THEODORE F. MOORS ., CE-35�F;i �c� 0"V', ., ei ofesslo��� �xw,Z%, :s LOT 19 SEPTICt AREA Ir. — INSTALL NEW cAx 1000 -GALLON SEPTIC TANK `*MAU NEW M.T. w TRENCH ;LOT 18 �E RETAIN `••.(VACANT) TRENCH — SEPTIC AREA LOT 17 LOT 7, BLOCK 7, SAND LAKE #2 SEPTIC TANK REPLACEMENT SfTE PLAN FLATTOPTECIINICALSERVICFS 11NCH=40 FEET 14530 ECHO CANYON ROAD DRAWN BY TFM ANCHORAGE, ALASKA 99516 _ MAY, 2010 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. INSTALL NEW 1000 -GALLON SEPTIC TANK SEWER LINE FROM HOUSE ........ ........ ..... . INSTALL DBL C.O. DECOMMISSION AT CONNECTION EXISTING TANK TO EXISTING SEWER LINE UPSTREAM OF STANDPIPE PLAN VIEW SCALE 1" =10' INSTALL DBL C.O AT CONNECTION TO EXISTING SEWER LINE UPSTREAM OF STANDPIPE 4V SOIL COVER INSTALL NEW 1000 -GALLON SEPTIC TANK'. PROFILE VIEW SCALE: 1" = 5' RETAIN SOIL AB: TRENCH INSTALL DBL C.O. INSTALL DBL. C.O. ELIMINATE EXISTING SUMP INSTALL NEW MONITOR TUBE 49 m .................. THEODORE F. MOORE CE - 3589 _, INSTALL INDEPENDENT MONITOR TUBE IN EXISTING TRENCH urFfattop TechnicafSemias 14530 Echo Canyon 4t9a4.Andiorage, .XX 99516 drone (90) 345-1355 Lot 7, Block 7, Sand Lake S/D #2 8309 Wilcox Street Septic Tank Replacement Specifications 1.0 General: 1.1 The scope of the project consists of properly decommissioning a failing 1000 -gallon steel septic tank and replacing it with a new approved 1000 -gallon deep -burial steel septic tank located as shown on the site plan. The tank shall be located no closer than 90 feet from the well on Lot 7 and 83 feet from the well on Lot 6, and shall be no closer than 3 feet from the north property line. 1.2 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. 1.3 The installer shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The installer shall provide adequate cover material and rough grading over the tank to ensure that proper drainage is achieved after settlement and that there are no residual depressions. 1.5 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. 1.6 The only feasible access to the east side of this lot where the tank is located is by coming in from Endicott Street across Lots 18 and 19, Block 7. Access from there will require that a portion of the wooden fence along the east side of Lot 7 be dismantled and then re -erected after the work is done. There is also a small shed in the vicinity of the septic tank that the contractor will probably have to tear down and remove as part of this project. 1.7 The owners of record for Lots 18 and 19, located at 8252 Endicott Street are Robert and Valerie Sprinkle, and their phone number is 248-9407. Mr. and Mrs. Sprinkle have tentatively agreed to allow access across their lots, provided it is done in such a way as to minimize damage to their garden area and raspberry bushes growing along thefence. As part of this project the contractor must first contact the owners to arrange how best to minimize any damage to their lots and restore it to comparable condition after the work it completed 2.0 Septic Tank: 2.1 The existing 1000 -gallon steel septic tank must be properly decommissioned by thoroughly pumping, removing the top and backfilling with soil. 22 The new 1000 -gallon steel, 2 compartment septic tank shall be Municipally approved and set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet it shall be insulated with 2 inches of rigid insulation plus 2 feet of soil cover. Z3 The 4" diameter ASTiif D-3034 sewer line coming into the tank -from the house shall be connected into the existing sewer line exiting the house at a point upstream from an existing cast iron cleanout pipe, and shall be equipped with a double cleanout installed near the point of connection to allow the waste line to be cleaned in both directions. 2.4 A second double cleanout shall be installed in the discharge line approximately S feel downstream of the tank prior to the point of connection with the existing soil absorption trench. 2.5 The existing soil absorption trench shall be retained in service, however the existing sump near its north end shall be bjpassed or eliminated and anew independent 4 -inch diameter perforated steel monitor tube installed in the trench. This shall be done by excavating down to expose the top of the sewer gravel to allow the perforated monitor tube to be pushed down to the bottom of the trench and then extended above final grade with 4"D-3034 The steel portion of the perforated monitor tube shall be fabricated so as to create a point on its bottom end and have an effective length of approximately 7 feet 3.0 Inspections: 3.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial discussion with the contractor to finalize the location of the tank and construction procedures, (2) after the tank is set level and piping connected but prior to backfill, and (3) after rough backfill and grading is complete. The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. X O J SAND LAKE LOT PLAT NO. P-176 SUBDIVISION 7, BLOCK 7 6,750 S.F. LOT 5 II II I I LOT 6 WELL Ig} N 90.00'00"E 135.00'(REC) SEPTIC SYSTEM S 89.57'23"E.:135.17'(MEAS) aS.J' 5.7' 6.4• 45.8' SEPTIC SYSTEM CARPORT GRAVEL DRIVE CONC. BELOW SHED N EXISTVMLOI G Vi .a,. BUILDING n CART LOT 7 GRacH - PORCH HOUSE DECK WELL S 89.57'23"E 1 135.17•(MM) N 90.00'00"E 135.00'(REC) I LOT 8 WELL SEPTIC SYSTEM - NOTE. SET 5/8" REBAR WITH YELLOW PUSTIC CAP STAMPED "LS -6091 AT ALL LOT CORNERS. GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWUNG RD., SUITE 8 ANCHORAGE, ALASKA 99507 PHONE 248-5454 GRID DATE 2224 5/7/2010 F.B. JOB NO. 10-02 SLS277 NO. 2 LOT 20A I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA ,W*S\ull1 •• OF .44 s•�1 .• AV *;•491" � 910 ml .....................: * i 0.........•.• .............40 IW : o : Jeffery A. Gastaldi : `: LS -6091 •J „�Ar •� 5 e^e0 n'••.u.H••'�•SyJ�� ♦����salms* ♦ 1 11=30' I LOT 19 I N O O h Z W W LOT 18 888 8 Z Z _ WELL LOT 17 II I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA ,W*S\ull1 •• OF .44 s•�1 .• AV *;•491" � 910 ml .....................: * i 0.........•.• .............40 IW : o : Jeffery A. Gastaldi : `: LS -6091 •J „�Ar •� 5 e^e0 n'••.u.H••'�•SyJ�� ♦����salms* ♦ 1 11=30' SCS Ret# 1096314001 PQL Units Mcthod Containcr ID Limits Client Name Flattop Technical Srv. Metals by ICP/MS Project Name/# L7,D7 Sand Lake #2 Printed Date/1'ime 12/04/2009 9:33 Client Sample ID L7,D7 Sand Lake #2 Collected Date rime 11/232009 14:30 MatrixReceived Drinking Water Date/time 11232009 15.05 1124/0912/01/09 NRB Technical Director Stephen C. Fde Sample Remarks: ParameterAllowable Results PQL Units Mcthod Containcr ID Limits Prep Analysis Date Date Inil Metals by ICP/MS Arsenic 72.0 • 5.00 ug/L FP200.8 C (<10) 1124/0912/01/09 NRB Waters Department Total Nitratc/Nitritc-N 0.144 0.100 m9tL SM20 4500NO3-1' Il (<10) 12/03/09 RJT Microbiology Laboratory Colony Count Total Coliform PccalColiform 0 0 0 col/l00ml. coU100ml. coU100mL SM20922211 SM209222B SM20922211 A A A (<200) (<I) (<I) 1123/09 1123/09 1123/09 DLC DLC DLC I Almlicipality of .Anchorage P0. Ikrx 196CM - Anchoragc. Alaska 91).519-6660 - Telephone (907) 3336901 - Par (fXY!) 3i3.&"(X) 47(X) I1rapaw• Sinct - Anchorage, Alaska 9A507 Mayor Mark Begich December 22, 2005 Gamess Engineering Group 3701 East Tudor Road, Suite 101 Anchorage, Alaska 99507 mimmunLorq Ihdlding Safcty Divislon Re: Request to Amend Waiver Number WR930065 Sand Lake #2 Subdivision, Block 7, Lot 7 Parcel ID# 011-132-30 Dear Mr. Gayness, Your request to amend the subject waiver issued November 8, 1993 to waive the required 100 feet separation from the water well on Sand Lake #2 Subdivision, Block 7, Lot 7 to the absorption field on Sand Lake #2 Subdivision, Block 6, Lot 17 is approved. The amended separation distance is 90 feet. This amended waiver approval applies to the existing water well to absorption field 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 questions regarding this waiver, please call our office at 343-7604. Sincerely,4UXDJ M U�1 '. Julie Makela, P.E. Civil Engineer II On -Site Water & Wastewater Program Community, Security, Prosperity Sand Lake #2 Subdivision, Block 7, Lot 7 Parcel ID: 011-132-30 Amended waiver for 90 feet from well on subject property to absorption field on Sand Lake Issued December 22, 2005 General See original waiver for relevent information ADEC Criteria Water Table Water level Assumed total depth of absorption field x=110/720+8.0 x=8.2 Soil Sorption 410 feet -10 feet 400 feet Points 8.2 4.7 (50/400 x 0)+(60/400 x 6.0)+(70/400 x 4.5)+(90/400 x 6.0)+(30/400 x 4.5)+(80/400 x 6.0)+(20/400 x 1.5)=4.7 Permeability 2.3 (50/400 x 0)+(60/400 x 3.0)+(70/400 x 2.0)+(90/400 x 3.0)+(30/400 x 2.0)+(80/400 x 3.0)+(20/400 x 1.0)=2.3 Water Table Gradient 0.0 No info Horizontal Separation 2.6 90 feet between well and absorption field x=15/25+2.0 x=2.6 Total Points 17.8 As per ADEC waiver guidelines a point value of 17.8 is almost sure to be free of any form of contamination from household sewage. 'MUNICIPALITY OF ANCHORAGE,1 r—, MUNICIPALITY h and Environmental Prote ion Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE QISPOSAL SYSTEM NAME `Or-%' —3' C2MN MAILING ADDRESS �Z�3 t1QkQ(---'---L-PHONE 217-(ollS LOCATION �!"' L1�. 5t LEGAL DESCRIPTION -7 SEPTIC TANK: p Q� DISTANCE _�o�l'""µ NUMBER OF 11 � FROM WCLL �O 5 MANUFACTURER MATERIAL S� COh1PARTIdENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY O651tALLONS. TILE DRAIN FIELD: � .�o�,—�pocn�• 1 1 TOTAL LENGTH f 'FOUNDATION NEAREST LOT LINE S � OF LINE 3 DISTANCE FROM WELL C,5.�� — F�Z # of Lines I DISTANCE BETWEEN LINES �TRENCH WIDTH-- ' IN. TOTAL EFFECTIVE ABSORPTION AREA 2>.Rq— SO. FT. LENGTH OF EACH LINE ^� 1 DEPTH OF FILTER DCPTI I: TOP OF TILL TO FINISH GRADE 3'S MATERIAL BENEATH TILE—T.;= IN. ABOVE TILE SEEPAGE PIT: DIAMETER _OR WIDTH_. LENGTH_, DEPTH Log Crib _Rings_ Crib Size:, OIAMETER_DEPTH_ DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION— NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. Well Class:Depth': Well Distance TO: Lot Line _ Bldg: Sewer Line: Pipe Materials: Lx*& cgXr-- # of Bedrooms: z Installer: Remarks: t„ I tL0 I DATE—'A-1, APPROVED C I jup — L.I_`_ —IIL — - DATE—'A-1, APPROVED C ✓LI 11.\IIILI�1 VI IILI IL 111 111\✓ LI\Y 11\VI\I ILI�IIIL 11\VILVI BVI• S25 'L._, STREET, ANCHORAGE, AK. 59501 279-2511 U P!K WF=L'L HMLr �C7t7—SITE SELJEr F= Ftt�1 �� 9L 71 W& PERMIT NO. C 778530 C� J� APPL'ICAN'T LOF:I UORAN 8223 WILCOX "l �23-�277 115 LOCATION W1L40X S�—" 'LEGHL L7B7 SANDLAKE SD#2 LOT SIZE + SQUARE FEET + TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS 3 SOIL RATING (SQ FT/BR)= 110 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: L�EFsTH= 14:7 LERtGTH= 2� GF�Fi�{EL ©EP'TH=c THE LENGTH DIMENSION IS THE LENGTH CIN 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 CIN 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 CIN FEET). REGU I REG SEFP'T I C:: TPFt+FK S I -E= 193IDID LiFiL_L CAr-.IS F_"(--KHGE F1L-RMT CAF�T I CA r4 A PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE 'FOLLOWING CONDITIONS: 1. EITHER A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. ---------------------------------------- -r:-- TLJCF C 2 ] F=iRE RECAU I REO ,---, BACKFILLING OF ANY SYSTEM WITHOUT'FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND"ANY ON-SITE SEWAGE DISPOSAL SYSTEM I5. 100 FEET FOR A PRIVATE'WELL!OR 200 FEET FOR 'A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO -THE DEPARTMENT WITHIN 30'DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='EFrtl I T EXP' I RES OECEMFIER nl1r nL"9 1 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: q=ty !== "sem ---- ---------------- APPLICANT ' LOP.I /DOORAN �J / ISSUED B Sh" v �� ---- DATE -- V3.0 P1Ut4 I CS I FAFAL_ I TY CAF FAt\FCHCAFQFAC3E r-rT r fJ t A�w a L' f ti1UNICIPAIITy OF ANCHOR ENVI DEPT' OF MEALTNg ACC ONMENTAL PROTECTION 'SEP 101986 p RECEIVED r�lir4I c I r-?'::( L_ a -r`,' or- r-�rscl-It:,, rz:f--i � /030iN DEPARTMENT 0 EALT;t nt4D ENVIRONMENTAL F' VECTION 0 , 825 'L' STREET. ANCHORAGE. AI:. 995ul 264-4720 L4 I-_- L_ f�_Cf2r'i I'T PERMIT 140. C 700074 ) 83oq wALO-l< nPPLICANT DARRELL WILKENING 7066 TERRY PLACE 243 2896 LOCATION MLCOX Sl 6 LEGAL L7 07 SANDLAICE S/D #2 LOT SIZE -PARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; 0R 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS OF THE WELL COMPLETION. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. f=`EI-�:M I T CrXr-` 12C- C7CCCME}CF< 71::1- 1 1'??L I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: " ------------ APPLICANT DARRELL 6ILICENING ISSUED E ---------- - - -DATE/�O/7_ V3. 0 f V DATE , SIGNED - - &111.ji/ 4S 4169 P.H Pi(SO r aw PART S WILL BE RETURNED WITH REPLY �� , I / Mae.;/ - I/ V DATE SIGNED RRdi7rm a SEND PARTS 1 AND S WITH CARBON INTACT 4S 4169 P.H Pi(SO r aw PART S WILL BE RETURNED WITH REPLY DETACH AND FILE FOR FOLLOW-UP MUNICIPALITY OF ANCHORAGE • ^' DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING o Parcel I.D.R If HAA tf—_FIDSIND I 1. GENERAL INFORMATION Complete legal description ka 1 -7 7 Sti exZ Le4.4 µz- Location (site address ordirections) 83012 (e/iIrg% Property owner 1011-111�0 Adr « Day phone —2y g — 4069, % Mailing address Jig wi %� Lending agency r* A Day phone Mailing address 1 Agent SL Qca &," d- Ro,-L4 LIL4 Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 V NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. nms in... irn+� rrwt MOA,21 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. �1 Name of Firm %Aey9 9DUP���c'��X Fl= (T-7 r'J%/(o Phone Address Engineer' CC -2225 6. DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments a tl ITIc Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragrapn o above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes • and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. - n-MJR. IMIJ Pwk _MOA 821 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 4476Y-7 5mwV664t Parcel I.D. 011-1-12-10 A. Well Data Well type zIf A, B, or C, attach ADEC letter. ADEC water system number NA Log present (YIN) Date completed 1617,9 Driller AL4t6y— ID'11" Total depth NoZ Cased to 919-1 Casing height 1 4 �I Sanitary seal (YM) Wires properly protected (YM) FROM WELL LOG AT INSPECTION Date of test y-8.79 91al1g3 Static water level 130 Well flow g.p.m. Pump Ieveil S.,:6 SEPARATION DISTANCES FROM WELL TO: J g.p.m. > /&0 Septic/holding tank on lot 85 — ; On adjacent lots I O'O Absorption field on lot C)!5 — ; On adjacent lots 97 f' 99 -9 ll Public sewer main NfA Public sewer manhole/cleanout '41A Sewer service line % I t> Petroleum tank N o " rz WATER SAMPLE RESULTS: Coliform (!/ Nitrate 0. Io U Other bacteria Date of sample: glxj •A -+s Collected by: SkLxft� IIF11:120aG[01419I elk 101114973�_t Date Installed 9/13177 Tank size / e-ct0 Compartments 2 Cleanouts (YM) Foundation cleanout (YIN) �1�Depression (YM) High water alarm (Y/N) N�/� Alarm tested (YM) NSA Date of pumping I q 3 Pumper NO o r1-4 1ow4 X SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot S,5 — On adjacent lots f olo Foundation ) .9—D To property line 1 I D Absorption field Water main/service line I D Surface water/drainage N O N 72-026(397)• Font CONTINUED ON BACK PAGE C. LIFT STATION NIA Date Installed Manufacturer Size In gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on' level at .Pump off" Level at High water alar level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water_ D. ABSORPTION FIELD DATA Date Installed ! Soil rating (GPD/FF) O System type �� 1 Length 3,Z Width 3 / Gravel thickness �o / Total depth 1 U Total absorption area 3 �� Cleanout present (YM) �� _Depression over field (Y/N) Date of adequacy test 1 /A I I k _Results (pass/fail) for 3 Bedrooms Water level In absorption field before test After test �r Peroxide treatment (past 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot lJ i On adjacent lots TZ Property line 8 To building foundation 6o 7 To existing or abandoned system on lot�i4 On adjacent lots;Z0y . 1� � Cutbank hi n -e Water main/service line Surface water IY 0 w Driveway, parkingIvehicle storage area �? .. D Curtain drain N c vte E. ENGINEER'S CERTIFICATION i I certify that 1 have checked• verified, or conformed to alt MOA and HAA guidelines in effect on the date of this inspection. ' Signature 7 t ' Engineers Name 7016beW soy irkin rt/ Date H 3 1 �t3c.. C4o� ............ HAA Fee $ -3 dD `C Waiver Fee $ l Date of Payment /O —41-7-3 Date of Payment 41( �L Receipt Number S % $Z (/�� y Receipt Number S �3 VS Y r 72-028(393)' Back Municipality of Anchjrage*D Department of Health and Human Services 825"L" Street Tom Fink, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 November 8, 1993 Tobben Spurkland, P.E. 203 West 15th Avenue #206 Anchorage, Alaska 99501 Subject: Wwaiver Request for Lot 7 Block 7 aiver Request #WR930065,PID#011-132-30,Sand Lake g #2 HA930611on Dear Mr. Spurkland: Your request for waiver(s) of the required separation of a septic system to a private The approved separation distance(s) are a Block 7 to the septic tank on Lot 6 Block well on Lot 7 Block 7 to the drainfield on 97 feet; a private well on Lot 7 Block 7 t Lot 19 Block 6 of 97 feet. 100 foot horizontal well has been approved. private well on Lot 7 7 of 95 feet; a private Lot 17 -Block 6 of o the drainfield on This waiver approval applies to the existing septic well separation only. Any future require all separation distances from this department. Sincerely, Daniel J. Roth civil Engineer On-site Services Program DJR/ljm upgrade to either be met or another system to will approval concur: /Robert W./Robinson Acting Program Manager On-site Services Program � n MUNICIPALITY OF ANCHORAGE Department of Health and Human Services • On-site Services Section Waiver Review Worksheet WR# WR930065 PID# 011-132-30 HA# HA930611 Permit # Date Received: October 4. 1993 Legal Description: Lot 7 Block 7 Sand Lake Subdivision #2 Engineer: Tobben Spurkland, P.E. 203 West 15th Avenue #206, Anchorage, Alaska 99501 Applicant: Bonnie Adrian Waiver Requested: Private well on Lot 7 Block 7 to the septic tank on Lot 6 Block 7 of US fppf• Private well onLot 7 Block 7 to the drainfield on Lot 17 Block 6 of 97 feet; private well on Lot 7 Block 7 to the Criteria: on 1. Geology k 6 of 97 feet. Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: x Waiver is NOT Granted: List Conditions or Reasons for above: _;5,Et A 77-,g <HF_O Date: //- f - 93 By: ewer •*•,ter Rec #: 25282/451 Amount: $ 920.00 Date Paid: 10-4-93 o r^ WfllVEn RcquEST fOR LOT 7 Loc 7 S.y,vv LASE Su W41VER REQI[EST NKMBER tvlR93soabr W,9)VEK /7EQ uE3T ./COR rhE DELL OA,- LOT 7 DLA' 7 re THE SE, CAI 'or 6 PLA' 7, rHE Pf,*IVF/E4P 0" L Or /7 VLk G .9wo r/-er PRN/u F/Etp ON L or /f LILY 6 fRom TKE REQu /TEt� /OD fEjr TO 9f, 9 7, f. r .97 Peer R E sPEo r/ SEL y. E pT/c p6 rR -- TNF 198S0RP70ov TREovCHfS owtor /7, /9 Pik / .9,00 see7,1c T17WH 0" Lor 6 84.k 7 wEW-1 41 evArrRucreo /N /f,77. rk1E WELL /A/ QuesPoN ov L or- 7 pL/S- 7 W ys pIP/l.t Ep IN I g76. B0r/f r/2ENCHE3- &AIO r"P- CONSTRucTEp AS If D�9C1r'HcW CII -Al DIG. SEPT/c 7-&,vh /,i, quESTr/aov ,q TN i /t S19-A'G L Rq'E S w /G t,, A ,o4t Ot',FO %HERE /S No SLOPE /a T,v/s �FREA. w"cvx Pf/VE Rlw /f 8Erc--EE'N TKE WELL /.v qurtTiov i¢,v0 mA k0sorjpr/om r7?£nrcHEr ov LOT /7, /9 04/t6, %KE 5EP77c r,9Nx OA., LoT 7 RLle 7 /S A GREEIQ STEED /000, 2 CoetPA/trmcyr rgNk, rAHEfE rHNKl RN/L r ouRiN6 rH/S ERo r1TTE0 wiry lkvERT3 Oa TKE /ti6E7,- 6urler d ro ur1L/-2E i nrER7/t,yT roarL/,VGS. ry /jpp/rVIV VEC,94n, T"tEi gRE ►�FLL ORAIA,Ep 5Wv01 � 6R4vCts TFfE /,v TEGq/7Y OF TK/f fC^ri r7A,K 1s RRo 0'+ el G,/(, fGNi/OGRLvs }lw� A' /Tf /$AGE. T/s+.vk 46 -we - — WF -LL VItTn — r-. THE W ELL /iv Q u E$ r/ON is 4ZI FEET DEEP. 7 -RC I:rWAV-6A WffTER' it ENCOu,vrERED tr ??oFeE7-. THG t+Ap ! 6Rp✓et 7lefi 7 -HE SEPT/G Sf SiEKS &t?E e*Ov rrRucTEO 1N Ea?F_.vD Ft?aAf T/-eE' r{0uA/0 jr uRPAcr re 60 FEET, THEN THE Seics FM VH 60 F"r 7- 7%E^ 7%E' w6rnt3 PROOriChvb /lQu IFFR /F-RJE PeVSE rs I WS , Avo S'.ANG, iH/s 1.-14TFR gr--RR/A,6 AQu/FE,Q uaDauBTi9QLy�Co,✓F��Ep FRo.� .5unr tcE toov rR o4l,,vA rIaN 1Y1GR,j9T7A16 Da�.vt-,*Rv ro 7r, rKE 09 42u1FER 11 ALSO UNDER PREssuRw: WH1CH 1J 1,v01c*7&p fle 77Ye GuRRcA., sT-1971c u-nrE2 LEOCZ of 130 FEET, SugRouNvlub 1✓ELI Lees IN THE RWE17 IAi01eR7-z- 7-H4T TH/J s e,t- f r/i)q�r/F7cA r1o" Ae vF,gr1-/ 7kz' blQoun.p tuRFn[E 15 te-'f) rMgitvlllUur rid F_ AREA. LLA E/Z fl}HnE3 F -Rom ME to-F_L1 /v cru ES71oAl 1pDicA-TES Tkr9T Na OA-crERlq +HE PRrsB.✓r ANO roa .✓irRgrES DETr, c7-*pLE lo�^ 2- vEL— fc�Ys. OF INnrr_ii 7-68LE ¢10 /0 ' s eir,o ociry = 4 oo ' 70� SOIL sonario/v W. G. {Or pD> o f ��� 6 t /4001 t Mo) + MA f/000/' RLFAQ1L fTY 0 400 400 400 3 400 LF NO f► -f0 O fpJD!{fzONTf}L SEPARf4T/yn, 20 x=.8* Z 2.8 G?, ,vp T oT!/L I8. a -Low Ct u s/o,v G /?A,vr A44WER r- 31 -r _ SF�UF2F< LAND F=J _ E 6751 W. DIMOND BLVD. ANCHORAGE, ALASKA 99502-3904 Lt�2 `13005 (907) 248-5095 Municipality of Anchorage September 30, 1993 Division of Environmental Health Department of Health and Social Services 820 L Street Anchorage, Alaska 99501 Subject: REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR PRIVATE WELLS TO SEPTIC FIELD LOT 7 BLOCK 7 SAND LAKE R2 Gentlemen; We are submitting a request for waivers from the separation distances stated in Title 18, Alaska Administrative Code, Chapter 80.020. A waiver was granted for this well in 1986 with respect to the septic tank serving this lot. The same waiver also waived the distance between the well on lot 6 and the septic tank on lot 7. The siteplan prepared at in 1986 indicates that the septic tank on lot 6 is 100+ feet distant from the well on lot 7. The true distance can not be measured directly due to the location of the house an lot 7. During a field inspection on Sept. 21, 1993 it was discovered that the top of the well casing on Lot 7 was 97 feet distant from a standpipe in the drainfield on Lot 17, Block 6, Sand Lake, and 99'10" away from a standpipe on Lot 19, Block 6. Lot 18 does not have a septic system. To avoid possible future requests for waivers we want to include all possible, unaddressed deficiencies in this waiver request. We therefore request the following waivers with regard to the well on Lot 7 Block 7 Sand Lake 42. 1. To septic tank on Lot 6 Block 7 95 feet 2. To drainfield on Lot 17 Block 6 97 feet 3. To drainfield on lot 19 Block 6 97 feet. We have included well logs for this well and for other wells in the general area. Total well depth ranges from 250 feet to 520 feet. Impermeable layers of clay and silt are common in all. Due to location of streets and buildings surface contamination of the well is not likely. The topography of the area is level. Yours Tben Spurkland P.E. LOT LOT 18 LOT 17 0 W 25 50 75 f00 125 SCALES P = 50 FT. II UBBLN SHUKKLANU N.E. I I LOT 7 BLOCK 7 SAND LAKE 2I I SEPTIC SYSTEM DESIGN I 203 W 15TH. AVENUE BONNIC ADRIAN DATE, SEPT. 34 1993 ANCH. AK. 99501 .on,. „o_ea,< 8309 V(LCOX SHEET- 1/1 GRID- 2004 E2.'tii - _ "wc.ri`i �II:6f]t�:Y:wA.t?+:•��::SSi' - �+..�<...aawia�a�.+ra...:r.a„++w.cu w.a.c.�nsar_..r...e.�..w.—..—.... Municipality of Anchorage Department of Health and Human Services Tom Fink. 825 " U' Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 June 8, 1989 Daryl L. Vaughn & P.O. Box 1304 Anchorage, Alaska Bonnie C. Adrian 99510-1304 Subject: Notification Of Failure To Meet Setback Distance Requirements For The Well On Lot 7 Block 7 Sand Lake #2 To The septic System On Lot 17 Block 6 Sand Lake #2 Dear Property Owners: It has recently come to the department's attention that the well on your lot and the septic system on the lot described above do not meet the separation distance requirements as outlined in the Anchorage Municipal Code, Chapter 15.55.060, Section A. This letter serves as your notice of violation to this code section. To resolve this matter, your well must either be properly abandoned and moved to a new location, or an application from a registered professional engineer may be submitted to us for waiver of the separation distance requirement. Until this encroachment violation is resolved to the departments - satisfaction, Health Authority Approval for your lot will not be granted for either sale or refinancing. If you have any questions of this notice, contact this office at 343-4744. Sincerely, Daniel J. Roth s civil Engineer Acting Program Ma1w On -Site Services SN IW a a W a N O V ON EE yt in $ •abiZ ,2 W U a, o N 0$_ay8 C ii d Y £ e o -4 D r_ 1r1 O1 \ ,�E`55F -1 3 $4 rn o m e z c ^i «=a� 0 Q a - pE. ;,_;s F d U) e b c`t Fo Z $4 atYEE y 7, u ° m.°c $O 1' N i OI"] Q f�i K O r �a Q W Q N N O Q C OEa=8 Y9 X «0 r; IM W X : ru m eu OCPCIPT Ps Fom13811. Juty 1997 -'— - -. - Parcel I.O. M O MUNICIPALITY OF ANCHORAGE • Department of Health &Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING D// / 3 Z3 u HAA# 1`2'L(7)6QL 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) I -o ! 7 /3 k 7 -q AN D LA1<1= 4 _Z - Location Location (address or directions) uKduc&�d k -t- ^�� —ag�Y (!"` (b) Property owner N ,� Telephone: (home) Business Mailing Address '�" ' Ryc'y- (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone A71-7 b It Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-FamilyXI Number of bedrooms 3 3. WATER SUPPLY Individual Well ❑ Communityx Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: y community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-MS(R«.WN) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system Is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on. the date of this Inspection. in Name of Firm I aybI i!E Telephone Address Date uL- �• l�g'8 6. DHHS APPROVAL Approved for 3 edrooms by Approved X Disapproved Terms of Conditional Approval ,:,,• � Engineers Seal /...:.iLt _ . ..,i o. 2225-E •••"� lu:1E -S. 1971 t Conditional CAUTION Date /D.. - / 3—kb' The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before certificate is issued. The Municipalityof Anchorage Is not responsible for errors or omissions in the professional engineer's work. 72-025(Ray. 7M) Back Page 2 of 2 N*MUNICIPALITY OF ANCHORAGE (MOA) 31 ',,.,1ALyof ANCHIatth� Authority Approval (HAA)EM SEzVICEPJIIEC"IST-FEBRUARY1984 -� 4744 DF(; 12 1958 Legal Description: • 4 y % r J• � s�t�O tett K z A. WELL DATA RECEIVED Well Classification S If A, B, C, D.E.C. Approved (Y/N)' NIA - Well Log Present (Y/N) _ D��ate Completed I� Yield & ;C "I Total Depth��i/ Cased to �Depth of Grouting aI" Static Water Level /�/ lPump Set Atf°""L� Casing Height Above Ground 16 Sanitary Seal on Casing (Y/N Electrical Wiring in Conduit (Y/N) _� Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot E 5 ; On Adjoining Lots 7r53�IFY To Nearest Edge of Absorption Field on Lot 1 C1 % ; On Adjoining Lots To Nearest Public Sewer Line N/4 To—Nearest Public! ewer Cleanout/Manhole To Nearest Sewer Service Line on Lo "S8I � Pr _ , • J , Water Sample Collected by Water Sample Test Results Comments 02err— E B. SEPTIC/HOLD Date Installed k—� > �r Sae n No. of Compartments Z Standpipes (Y/N�Air-tight Caps (Y/N) —Foundation Cle no/ut (Y/N) Depression over Tank (Y/N) —N Date Last Pumped 12�61`yft a ltcf j� Pumping/Maintenance Contact on File (Y/N) ;for ly�� Holding Tank High -Water Alarm (Y/N) by—a Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well S -,C— wk��D Iii To Building Foundation 3n 14 To Property Line / � 01 To Disposal Field To Water Main/Service Line i 10 To Stream, Pond, Lake or Major Drainage Course WIA Comments 72-026(A". 7/66) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorp ' O Type of System Design Date Installed g 3 % b, 33 Length of Field 3 Z Width of Field r Depth of Field Gravel Bed Thickness Square Feet of Absortion Area 7 Statndpipes Present (Y/N) e' " Depression over Field (Y/N) _ t4 Date of Last Adequacy Test h &, Results of Last Adequacy Test - -f' as 5 SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well iv % To Property Line To Building Foundation J To Existing or Abandoned System on Lot On Adjoining Lots > % S To Water Main/Service Line To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area 5 a Comments D. LIFT STATION • N Q N'I,= Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions —'Manhole/Access (Y/N) "Pump Off' Level at Vent(Y/N) "Check Permitted Bedroom Rating Against HAA Request" _ Pumping Cycles during Adequacy Test. I certify that I have checked, verified, r conformed to all MOA and HAA guidelines in effect on the date of this Inspection C /[ q it Signed Company �FC) 7 4,_4 Sb d ik( J,t Date *:r'p Engineer's Seal .� MOA No. Receipt No. Date of Payment 12- Amount: ZAmount: $ 170.,06 72-M (Rev. 7/88) Back i' 2225-E / �� 1 .:E 2S, 1971 Receipt No. 7(1 Waiver Fee: $ Date of Payment Page 2 of 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION "(3L^- 101 -kg ApplicationDate (a) Legal Description (include lot, block, subdivision, section, township, range) r,i/_ 7 SANJr) LAKE SL)A'aZ 712- IV R qU) SEC /O Location (address or directions) Fwcl W/L CO>C ST. (b) Applicant Name' C EM SM 169 Telephone: Home 62-M-376 Business ApplicantACclress`; I&Q1 SMWAM #301 MELS, MM �'t y3 (c) Applicant is (check one): Lending Institution 0 ; Owner/builderrg; Buyer 0; Other O (explain); (d) Lending lr4itution` f Telephone Address 14 w In (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Familypt Multi-Family0 Other Number of Bedrooms S 3. WATER SUPPLY Individual Well t( Community 0 Public[3 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11184) 5. ENGINEERING FIRM PROVIDINta INSPECTIONS, TESTS, FILE SEARCH, DAD A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date — 1 //-SD ro 00 ee 0�• �•��•• •• 0.EID, 0. JR. �jc�22st ; *`A 6. DHEPAPPROVAL Approved for bedrooms by '� �""`� Date ve Approved Disapprod Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025(ii/b4) 1MlIJIQ"U'y OfANDOt4UUNICIPALITY OF ANCHORAGE (MOA) bN► OF i lito 6 ��IEALTH AUTHORITY APPROVAL (HAA) /fA119t0►ERtpFI SEP CHECKLIST 84 FEBRUARY 19 10� RECEIVED Legal Description: (37 L 7 SAND L AKe #Z TI ZN R NW SEC.10 A. WELL DATA Well Classification Mutq TF If A, B, C, D.E.C. Approved (Y/N) AIM Well Log Present ION) Date CnonmplleeteQ Yield a, 09' GPM Total Depth yet Cased to � 7�+— Depth of Grouting VIA Static Water Level1 y S• $ Pump Set At !l NKNau/N i 11 Casing Height Above Ground 1. 3 Sanitary Seal on Casing ION) Electrical Wiring in Conduit &N) Depression Around Wellhead (Y(@ Separation Distances from Well: �rt To Septic/Holding Tank on Lot gs ; On Adjoining Lots 100 / 100r-1' To Nearest Edge of Absorption Field on Lot _X07LVl_ ; On Adjoining lots ' To Nearest Public Sewer Line N/ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot N�A Water Sample Collected by �3 E L K A 1'fG}+ QC K ; Date 12.5119(a Water Sample Test Results S A 115 FAGt0R i -- - Comments -X SEE AimcHM Rl L S REPORT B. SEPTIC/HOLDING TANK DATA Date Installed 9 �z �7� Size 1000 No. of Compartments 2 - Standpipes Standpipes (9N) Air -tight Caps ON) Foundation Cleanout QN) Depression over Tank (Y© Date Last Pumped 9127186 Pumping/Maintenance Contract on File (Y/N) A11R ; for NIA Holding Tank High -Water Alarm (Y/N) -MATemporary Holding Tank Permit (Y/N) WA Separation Distances from Septic/Holding Tank: To Water -Supply Well 86 To Building Foundation To Property Line S To Disposal Field 17 To Water Main/Service Line A/A To Stream, Pond, Lake, or Major Drainage .. _: �,' IOD 2� Course' Comments Page 1 of 2 d e' 72-026(11,84) B71- 7 .s*+NO 1-,4 Ke 02- C. 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 110 Type of System Design rp Date Installed /�!� 27 Length of Field --52-" Width of Field i Depth of Field --= ' ' 9 5 ' Gravel Bed Thickness ig Square Feet of Absorption Area Standpipes Present ©/N) Depression over Field (Y,e Date of Last Adequacy Testek� ,�G Results of Last Adequacy Test sArrs FA _7oRY Separation Distance from Absorption Field: To Water -Supply Well 107 To Property Line 8 To Building Foundation S 5 To Existing or Abandoned System on Lot tyllA ; On Adjoining Lots • 12 z'f" To Water Main/Service Line N 1A To Cutbank (if present) - AI/A To Stream/Pond/Lake/or Major Drainage Course 1007) ,� To Driveway, Parking Area, or Vehicle Storage Area 2_ iI- Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Check Permitted Bedroom Rating Against HAA Request •• Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA Icertify that: lha4v ked v rifie or conformed to all MOA nd HAA guidelines in effect on the date of this inspection. Signed Date 86 Company INIC, MOA No. - 6' 0Z f Receipt No. `{bol Date of Payment Amount: $ ATTRcHMEN7S I b wRtvER Page 2 of 2 442- W ELL- L OG 3 DReIa pEif `9 REPoRT 72-026(11,841 y W$TER SAM)Oze #s 5ire FIA/Y .-M-W DRILLING INC.3 P.O. BOX 110378 ANCHORAGE. ALASKA 99511 ort. PHONE 349.8535 LEGAL DESCRIPTION Z7 p 7,SOwa- Z& o307 5L�� LEGAL OWNERS BANK OR LENDING INSTITUTIONS CURRENTLY MOLDING DEED Of TRUST NOME►NONE WORKPHONE r1 INVOICE No 3557 DATE �` 96 UNIT MATERIALS PRICE AMOUNT 0 WORKMAN DATE IN OUT HOURS RATE All charges shat/ be paid in lull within ten �%—�/- ' >:j LABOR CC days unless other arrangements are made prior to drilling. The Customer shall pay in- MATERIALS IFROM ABOVE) terest at the rate of 1 K % per month on any OTHER CHARGES amount not paid within ten days. failure to pay may result in a lien against the property. CUSTOMER SIGNATURE PAY THIS AMOUNT —► f?l� O TOTAL MATERIALS WELLNUMBER DIAMETER DEPTH STATIC LEVEL GPM DRA WDOWN 6 " 30� �- S' PUMP MAKE HP SETTING VOLTS PHASE AMPRATE SERIAL NUMBER MODEL SCREEN LENGTH SLOT SIZE LINERISCREEN DESCRIPTION OF WORK DATES — _ (� 0 WORKMAN DATE IN OUT HOURS RATE All charges shat/ be paid in lull within ten �%—�/- ' >:j LABOR CC days unless other arrangements are made prior to drilling. The Customer shall pay in- MATERIALS IFROM ABOVE) terest at the rate of 1 K % per month on any OTHER CHARGES amount not paid within ten days. failure to pay may result in a lien against the property. CUSTOMER SIGNATURE PAY THIS AMOUNT —► f?l� O FAQ Municipality BOX 6650 ANCHORAGE, ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 Anchorage TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH 6 HUMAN SERVICES October 3, 1986 Jeff Kaitchuck Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 7 Block 7 Sand Lake Subdivision 62 Waiver Request, WR86-137 Dear Mr. Kaitchuck: Your request for a waiver of the 100 foot separation required between the septic tank on the subject lot and private wells serving the subject lot and the adjacent lot to the north (Lot 6 Block 7) has been granted. The required separation distances have been waived to 85 feet for the well serving the subject lot and waived to 75 feet for the well serving Lot 6. The owners of the well serving Lot 6 have been properly notified and have not voiced an objection to this waiver. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw i Municipality P.O. BG.. 196650 Q !,��� ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY NNOWLES. Anchorage MAYOR DEPARTMENT OF HEALTH 8 HUMAN SERVICES September 17, 1986 Ronnie and Adriene Stock 8253 Wilcox Street Anchorage, Alaska 99502 Subject: Waiver of Separation Distance Requirement Between the Septic Tank on 8309 Wilcox to the Well on 8253 Wilcox Dear Mr. and Mrs. Stock: State and Municipal code requires that private wells be separated from septic systems by a minimum of 100 feet. The septic tank on the lot adjacent to yours (Lot 7 Block 7 Sand Lake 02, 8309 Wilcox) is located only 75 feet from your well. The owners of this lot have applied for a waiver of this 100 foot separation requirement. You are being notified of this waiver request under the provision of Anchorage Ordinance 15.65.150, which requires that property owners which may be affected by a waiver decision be properly notified. Please consider this letter as notification that this waiver request is currently under consideration by this department. If you have any objection to the granting of.this waiver, please contact this department within ten (10) days of receipt of this letter. If you have any questions regarding this matter, please contact me at 264-4744. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw cc: Jeff Kaitchuck A.E.C.S., Inc. ,11200 West 33 Avenue, Suite B 99503 Ln m m m .n .n N 19 w c� � oQ d J Q 2 d L 'v IL y' U O O, u, o, NYS J' s6"'s N K o O1 V N a a o`E�ySu; CLGo G r �n Ln . zest•gej'f M - L Ic } . v 3 i d a r J : O r � QoETURNRH pp�AESTIC R 60461 roN ALASKA �WROC1 nTAL COfIT M SCS DICES, InC. Enginttring 6 Enuironmenlal Studies KAREN LARGENT FORTUNE PROPERTIES 3000 A STREET SUITE 101 ANCHORAGE ALASKA SELLER—CHERYL SMITH LEGAL:SANDLAKE x2 LOT 7 BLOCK 7 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE -8/25/86 9/9/86 KAREN LARGENT FORTUNE PROPERTIES 3000 A STREET SUITE 101 ANCHORAGE ALASKA THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 384 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 914 GALLONS. ffy!MD UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A '3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TASK/PACKAGE PLANT WAS PUMPED ON 8/26/86 . THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WELL WELL FLOW DATE -8/25/86 THE WELL FLOW RATE WAS 6.09 GPM FOR 2.85 HOURS. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. 1200 Wtsl 33rd Autnut. Suitt B • Anchorage. Alaska 99503 • (907) 5615040 n ALASKA b UIROW11TAL C011TROL SEMINS, InC. Engineerinq 6 Enuironmenial Studies MUNICIPALITY OF ANCHORAGE • DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION September 3, 1986 Department of Health & Human Service tSEP 101986 825 Street RECEIVED Anchorage, Alaska 99501 Re: Sand Lake Subdivision x2, Block 7, Lot 7 On August 25, 1986 we performed a health authority inspection on the subject lot. After concluding the inspection, it was determined that the separation distance from the well to the septic tank is in violation of existing separation distance requirements. This distance was waived at the time of installation by John Kennedy and approved by Cory Willis on September 23, 1977. Since ADEC invalidated all waivers issued by the MOA prior to 1984 this situation must be re-evaluated. The Separation Distance Waiver Guidelines issued on a memorandum from Bruce Erickson, District Office Coordinator, State of Alaska, Department of Environmental Conservation, dated January 3, 1985, suggests that the geological conditions be addressed separately. The water table is 136' below the on-site sewer system Point Value = 7.1 Q Soil Type: Gravel & Clay 90, Soil Sorbtion Point Value = 6.0 [--" �•� Permeability Point Value = 2.0 moo• Water Table Gradient is a negative 63% slope �� PZZA ^� Point Value = 0.0 2.9 Horizontal Separation from the well to the septic tank 85'. Point Value = 2.4 Total Point Value = 17.5 According to the guidelines, the total point value of 17.5 shows that almost no bacteriological contamination is possible. A water sample taken on August 25, 1986 was free of coliform bacteria. The subject lot is level. The well log Indicates gravel from 0 to 60 feet, and clay from 60 to 120 feet, and total depth is 421 feet. This indicates a 60 foot layer of clay between the septic tank and the water table. We feel that the reduced horizontal separation distance does not constitute a health hazard. Therefore we request a written waiver for the separation distance of 85 feet from the well to the septic tank be granted. If you have any questions please feel free to contact our office. Approved: Sincerely, Jeffrey T. Kaitchuck Engineering Technician Suite B • Anchorage, Alaska 99503 9 (901) 561-5040 ,OLD' FF•.1 A10�'►7DRT CHOKE:iAe�N n.U4 ass, W oa: • XAirLt I tU $T DATE COLLECTED -, DAT . I.O. 00. (PUBLIC'SYSTEMS) SYSTEM CITY STATE WHERE SAMPLE WAS COLLECTED BY: iiATER MIALTSI5 TYPE OF �1'STEM l r AN ❑ PUBLIC INDIVIDUAL CIRCLE CLASS A e r. ZIP CODE U ❑ RESUBMIT SAMPLE Semple rejected because: CHECK ONE OR MORE ❑ Sample too long in transit. Sample should not be over 30 hours. ❑ Sample received too late in week ❑ Not in proper container ❑ Leaked out ❑ Insufficient information provided. 0P ease read instructions on form. ❑ ther (Specify) RECEIVED TYPE OF SAMPLE ( (CHECK ONLY ONE THIS COL ) RECEIVED BY O DRINKING WATER ❑ CHLORINATED DATE 9_1101e.fl6 TiME Coliform/InOml ✓CHECK TREATMENT ❑ FILTERED ANALYTICAL METHOD: UNTREATED OR OTHER U*MBRANE FILTER ❑ RAW SOURCE WATER ❑ FERMENTATION TUBE ❑ NEW CONSTRUCTION OR REPAIRS ❑ OTHER(Specify) Date 3 Time Started -.1-1-466 IS THIS SAMPLE A CHECK SAMPLE TO A PREVIOUS NON -CONFORMING SAMPLE? Date & Time Completed 741, �•st� m ❑ YES 0 PREVIOUS COLLECTION DATE ANALYSIS REQUESTED (IF OTHER THAN TOTAL COLIFORM) LABORAT Y RESUL�S Analyst 2' . -tyacS ❑ SEND REPORTITIO:(PRINT FULL NAME.ADDRESS AND ZiP CODE Other Bacteria NAME „ Ecfs I A(L t -` -(3 Test unsuitable because: Q ADDRESS f C� U/ � �+ i��/� �g ❑ Confluent Growth CITY AIYC{ STATE_ ZIP 99503 ❑ TNTC SATISFACTORY UNSATISFACTORY ❑ P.M. BACTERIOLOGICAL WATER ANALYSIS RECORD FOR LAB USE ONLY READ SAMPLE COLLECTION INSTRUCTIONS ON BACK OF FORM TOTAL COLIFORMS Membrane Filter: Direct Count O Coliform/InOml Verification: LTB BGB FECAL COLIFORMS aColiform/100m1 OTHER Final Membrane Filter Results Reported By Date Time A.M. P.M. READ SAMPLE COLLECTION INSTRUCTIONS ON BACK OF FORM ALASKA ENVIRONMENTAL CONTROL SERVIC"�, INC. �.- 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 JOB�! L6oZ g -SAND LAKE 02 SHEET NO. OF CALCULATED BY TI rK DATE 829186 CHECKED BY DATE tut 1'.A MUN,JPALCP F AlIK-1-1f2A 5. LEGAL DESCRIPTION ! 47- %LK riliNT� MUNICIPALITY OF ANCHORAGE ENVIROr: 'tNTAL KLOTLCTION ' DEPARTMENT OF HEALTH A ENVIRONMENTAL PROTECTION V 825 L Strom . Anchoreae. Ateska 99501 J U L 1 1 1979 ENVIRONMENTAL ENGINEERING DIVISIONR E C E I V E Telephone 264.4720 NUMBER OOM REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be pronee seL Plow sllore ten 1101 days for processing. 1. PROPERTY OWNER �PA/? ek<. (4 F7-# W/1.)<0A/r.Vr� IPHONE 'f3-65'11 MAILING ADDRESS 7. WATER SUPPLY crfs�. aLLiNt WI gBSoi PROPERTY RESIDENT (If different from Wovel PHONE Ll".3-09 ❑ PUBLIC UTILITY depth (attach log if available.) 2. BUYER eeif individual/on-site, give installation date /97 i O!'o"" PHONE If system is over two (2) years old an adequacy test is required MAILING ADDRESS by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. t 3. LENDING INSTITUTION 7Z&.D 1h liz: ETc a 3 w L� PHONE MAILING ADDRESS 0 CI 0 �t/o w !✓f o 7s q�ia 4. REALTOR/AQENT C7q /A+CK PHONE ���-`�� �✓` MAILING ADDRESS %VC] CJ,3�t� (t3. �9vo3 T 6T 71 5. LEGAL DESCRIPTION ! 47- %LK riliNT� L RK a Z STR ET LOCATION 3 Z) 9 t,// S. TYPE OF RESIDENCE NUMBER OOM ❑ One ❑ Four ❑ Other �3� SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY EFF --Three ❑ Six 7. WATER SUPPLY o N F I c- c �i:- a�INDIVIDUAL' 'ATTACH WELL LOG. Awell log isrequlredfor all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) a. SEWAGE DISPOSAL SYSTEM eeif individual/on-site, give installation date /97 i O!'o"" 1NDIVIDUAL/ON-SITE" If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) oil zvxw THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED - TIME TIME IME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: t. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED nD 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY_ Connection Verified PERMIT NUMBER DATEINSTALLED -, INSTALLER SOILSRATING D ❑Septic TRik or ❑ Holding Tank Size: /fw If Tank is homemade give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption- Area Sevver Line west Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter musty certificate) 13 DISAPPROVED DATE BVTitle 44 LEGAL DESCRIPTION 2-0i 0 PIev. of rai MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH a ENVIRONMENTAL PROTECTION SM L Sunt - Andwraee, AWIa 58601 Lot 7, Block 7, Sandlake Subdivision ENVIRONMENTAL ENGINEERING DIVISION \ , �,• Telephone 284.4720 d\} REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete NI Peru on Pa" 1. Ineonglere Mavens will not be pressed. Flare allow ten (101 days for pronuine. 1. PROPERTY OWNER PHONE Darrell It. Wilkening and Beth M. Wilkenin 243-4282 MAILING ADDRESS 8309 Wilcox, Anchors e, Alaska 99502 ham abo el E PROPERTY RESIDENT III differentPHONE 2. BUYER 7. WATER SUPPLY CR INDIVIDUAL' MAILING ADDRESS LENDING INSTITUTION PHONE First Federal Savincis 6 Loan Association 1 274-6561 MAILING ADDRESS P. 0. Box 4-2200 Anchorage, Alaska 99509 4. REALTOIUAOENT PHONE MAILING ADDRESS S. LEGAL DESCRIPTION Lot 7, Block 7, Sandlake Subdivision #2 STREET LOCATION 8309 Wilcox, Anchorage, Alaska 99502 S. TYPE OF RESIDENCENUMBER ❑ One ❑ Four ❑ Other 9 SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ® Three ❑ Six 7. WATER SUPPLY CR INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1978. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM 877 "If individual/on-site, give installation date ® INDIVIDUAL/ON-SITE" If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72d1013178)'� . ! LOP Of' fJ r' f LOP / I� THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECED IVE TIME DATE TIMETIME DATE DATE INSPECTOR INSPECTOR INSPEcrop DIRECTIONS: 1. TYPE OF RESIDENCE 'E1 SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER of BEDROOMS ❑ ONE THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2 WATER SUPPLY "4i7 INDIVIDUAL ❑ COMMUNITY C1 PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3 SEWAGE DISPOSAL SYSTEM *fDINDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified 'ElSeptic Tank or ❑Holding Tank Size: f. Lam, If Tank is homemade give dimensions: PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic (ding Tank AMorption Area im of m AMorption Arw to marts Lot Lina 5. COMMENTS S3 -'APPROVED FOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must a000 ny oertificate) ❑ DISAPPROVED DATE nI Gn / I / ' l v By ( 1 C LEGAL DESCRIPTION ».mn to�. ones