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Home My WebLink AboutSOUTH LAKEWOOD HILLS #1 BLK 5 LT 3South Lakewood Hills Block 5 Lot 3 #015-151-34 Nov 12 ?;•i u5:utip Ancho ags Ve!l & dump �,)r_ 4; Uro' P.? Parcel Identification Number: 015-151- 3 Lj Legal Deseription Property Owner Naine & Address: Pump lr;stallatinn Date: 1 I'umlr Isitake Depth 13ei'OW "1'ap oi•Vrell I.aseng: 21.5-0 feet I'urnp I'slanufaetaurer',s Name:` ' ��,''j I"urttlj i<Totiei: "��•1—` _�--�%� �.� Pump Sine 'Xi lit) PirkLs3 Adapter BurbI Depth;: Leet Pitless Adapter VIanufaicturer's name- Yitless Adapter Installer: Well Disinfected -upon Completion? zy'ss J N0 Method of Disinfection: 'Comments: IL Puqip Install r Nae: � nc tl Attention: The pun;p installer shall provide a pump instaltation log to the DST) within 30 days of putt:p installation. i:n. I. �4. r s F..sCa�..9:'�:':" -1, w;T' i �i;'Q-W?`eRreC':'t?'W" Op`✓Lyra"pq 470,- 2nad u �V.at*secVch A.--hog;.q_., r` K'i 95)07 I'"07J .343- K-4 Pump Installation Log Well Drilling Permit Neember::iW __ Datc of I3slat: Parcel Identification Number: 015-151- 3 Lj Legal Deseription Property Owner Naine & Address: Pump lr;stallatinn Date: 1 I'umlr Isitake Depth 13ei'OW "1'ap oi•Vrell I.aseng: 21.5-0 feet I'urnp I'slanufaetaurer',s Name:` ' ��,''j I"urttlj i<Totiei: "��•1—` _�--�%� �.� Pump Sine 'Xi lit) PirkLs3 Adapter BurbI Depth;: Leet Pitless Adapter VIanufaicturer's name- Yitless Adapter Installer: Well Disinfected -upon Completion? zy'ss J N0 Method of Disinfection: 'Comments: IL Puqip Install r Nae: � nc tl Attention: The pun;p installer shall provide a pump instaltation log to the DST) within 30 days of putt:p installation. Municipality of Anchorage i =4 • �, 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 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report SW030228 Z5-151-34 Permit Number. PID Number. Nome: PHYLLIS &BRUCE JOHNSTONE Wastewater System: ❑ New ■ Upgrade Address: 11101 MAGNOLIA STREET * ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 346-1575 4 0Deep Trench ■Shallow Trench 0Bed 0Mound Oother LEGAL DESCRIPTION sw fu a w 0.8 Tow Depth mom erlelnd erose: 9.0 MAX DPona R pt Block Lot. Subdivision: asset to pie boom *am OrWnol pod« Gavel depth beneath pipe 5 3 SOUTH LAKEWOOD HILLS #1 5.0 MAX n 4.0 n Township: Range: Section: - - - Io oases ono.. orq Iva« Gavel IMptn: 2 38 TOTAL) SEE DWG. n ® (76 R WELL: [I New [IUpgrade Orval widow 5 Nomnw of ones:al.— 2 Oebeee Yue 15+ n p< cw.r"twn PN *4 A.e.c Taw Cawed To: Total absorption 760 Plpe ma4rgh D 3034/ F-810 R pt. so. pt armor. Date oreled: Stott wabr is vel: hHasw: AKWWC, INC. Dots Mored: 7/2-8/2003 FL T1MG Pomp $et AC CaWq HHpm Above Gww TANK CP„ R n SEPARATION DISTANCES ■Septic OHolding OS.TZP. nether To Tac�FonaHl k wd Station Ta kg »an,d s. =' A TANK 1250 "1250 From Well too'+ too'+ - - 25'+ Yawid. STEEL w~w of 2 Surface Water 100'+ 100'+ — — — LIFT STATION Lot Une 5'+ *1'+ — — _ sus in gwww Yanaracaa.r Foundation 5'+ 10'+ — — — "bwl at en at tion water awm of Curtain Drain NONE KNOW Pup Yat. Oec4fN supeaoo•w Psdanwd t7 Remarks: BENCH MARK Loa and D..wraoon: OLD SEPTIC TANK WAS COMPLETELY ABANDONED. BOTTOM OF SIDING ® PORCH *LOT UNE WAIVER GRANTED. Aeewnwd ee.albn; 100.00 it ENGINEERS SEA oF 4p Inspections performed by: AKWWC, INC. Dates: 1st 7/2/2003.'..::. 4 .. :. �0 2nd 7/3/2003 3rd 7/7/2003 DQ QQ P :: { Ga ness Development ervices Department Approval Q0'4 5 44�p0"p, w Reviewed and approved by: Date: tR« 12/011 t 0 orasstoa t 4Ooo;� U PERMIT NUMBER: AS-BUILT DRAWING PARCEL ID NUMBER: SW030228 015-151-34 NEW DRAINFIELDS EXISTING CONCRETE SEEPAGE PIT WAS ABANDONED IN PLACE FOR \ POSSIBLE FUTURE USE. UNDOCUMENTED TRENCH MUST BE PROPERLY DISCONNECTED TO MAKING ACONNECTION — —PRIOR TO THE SEEPAGEAGEPITPIT J 10' UTILITY EASEMENT y SHED UNDOCUMENTED TRENCH Y.WV CARPORT i aY I �0�11 �3tZ 7H/1 i1 -- T2 WELL OBL1 \ \ NEW 1250 GALLON A B A B DBl2 \SEPTIC TANK 5T1 129.05 77.15 MTI 122.69 78.98 — — — — —\— — ST2 135.57 85.27 CO2 149.57 110.97 S' UTILITY EASEMENT DBL1 136.25 87.00 MT2 147.36 109.66 — — — — — \ DBL2 136.73 88.16 CO3 129.05 77.15 NSTALL :Low \ FS 136.46 88.64 MT3 135.57 85.27 SPUTTER CO1 121.54 76.24 C04 136.25 87.00 \ MT4 136.73 8816 DATE: op6�4 7/11/2003 0 �F• .A. G F .. •. S�0 DRAWN BY: ALASKA WA oERiTA`�NTWASTEWATER SGA<E�C_J 30 �: 3)0E TMOR ROAD SIr TF IDI • AVCeOOAGF. AK 9050) • PN(1NF (C0)US)-0AO • FAX (07),138.3746O : Q PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PHYLLIS & BRUCE JOHNSTONE (907) 346-1575 1 2 OF 3 QQ a `r Qa A '•, y A. Go ess- �J E 7953 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS SUBDIVISION; LOT 3, BLOCK 5, 40�d 0�4pp000 p,o llSSTo oar TYPE OF WORK: AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE PERMIT NUMBER: AS -BUILT DRAWING PARE -0 NUMBER: SW030228 015-051-34 FILTER TOP OF I INLET INVERT OF AT INLET - INAL GRADE 94.83 (AVG.) NEW 1250 GALLON SEPTIC TANK FINAL GRADE - 90.99-91.25 IIGINAL GRADE 90.99 O HIGH POINT 9TVERT OF PIPE - 85.01 (AVG.) TOP OF TANK AT OUTLET - 89.83 `INVERT OF BUNG AT OUTLET - 89.10 FINAL GRADE - 93.15-94.68 ORMINLIL GRADE 92.90-93.32 DTT OF PIPE - 88.34 M OF . 64.32 BOTTOM OF TRENCH - B1 -10'I RELATIVE ELEVATON OF BOTTOM OF . RELATIVE ELEVATION OF BOTTOM OF TESTHOLE - 78.82 (TEST HOLE D TESTHOLE - 75.49 (TEST HOLE DRP) DATE: �pdp 7/16/2003 n. -.. _ �'�Ai.?'l►: ,—+ DRAM ALASKA «TATER &; WASTENNTATTR CONSULTANTS. INC. 3701 E. TIMOR ROAD, SURE 101 • ANCH(WAGF. AK 09507 • FNONF (901)331-0119 • FAX IOOA33A.37tA PREPARED FOR: PHONE NUMBER: PACE PHYLLIS do BRUCE JOHNSTONE (907) 346-1575 LEGAL DESCRIPDON: SOUTH LAKEWOOD HILLS; LOT 5, BLOCK 3 TYPE OF WORK: PROFILE AS—BUILT OF SEPTIC SYSTEM UPGRADE A.J.G. N.T.S. .......... ............. NUMBER: 3 OF 3 ei ey �n ss- QQO o C 7953 rem• ..... '� cOAv4 MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade 3--Z'•3aFYV--. Date Issued: Jul 01, 2003 Expiration Date: Jun 30, 2004 Permit Number: SW030228 Parcel ID: 015-151-34 Legal Description-NSOUTH LAKEWOOD HILLS #1 BLK '5 LT_ 3. Design Engineer: 0041 AK Water & Wastewater Consuitarn Site Address: 011101 MAGNOLIA ST Owner Name: Phyllis & Bruce Johnstone Lot Size: 30400 SO. FT. Owner Address: 11101 MAGNOLIA ST Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516-1847 This permit is for the construction of., ❑✓ Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage i 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 tailing (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, sealed, and heated to prevent freezing. Received By. Issued By. Date: /-1-03 Date: 7— /- 03 Municipality of Anchorage • +.el a i0' '1:c:p Development Services Department Building Safety Division On -Site Water & Wastewater Program • r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-151-34 Permit Number 3 Z Property owner(s) PHYLLIS & BRUCE JOHNSTONE Day phone 346-1575 Mailing address (2) Zip Code 99516 al Legal description (Lot, Blo k & Sub'd.) S SUBDIVISION Legal description (Section, Township & Range) Lot Size -;; 0 y QC) Acres/Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 0 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees:—IIJIJ• Date of Payment: (0-195-03 Receipt Number: 57 Co 19 Waiver Fees: � 150 • - Date of Payment: 6 •VD5 _03 Receipt Number. _ .39615 ALASKA WATER & WASTEWATER CONSULTANTS. INC. June 20, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic Upgrade for Lot 3, Block 5; South Lakewood Ilills Subdivision To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system consists of a 1250 gallon septic tank and a crib and trench type drainfield. The drainfield is surcharged and must be upgraded prior to selling the house. A test hole was excavated south of the existing drainfield. The drainfield will be designed around the 30 foot radii of this test hole. We are proposing that a 1250 gallon septic tank and dual 5 -wide type drainfields be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.8 gallons/day/ft2 should be used. 2. TRENCII DESIGN: a. Percolation Rate: 8.3 & 10 minuteslinch b. Proposed Application Rate: 0.8 gallons/day/112 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750 f12 f. Total Depth: 9 feet (max.) g. Effective Depth: 4 It. Width: 5 feet i. Reduction Factor: 0.5 j. Minimum Length: 2 @ 38 feet long each (76 feet total length) k Effective absorption area = 760 R 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 • Website: akwwc.com 4. TOPOGRAPHY: The area for the proposed drainfields is a 10-15 percent slope running approximately southeast to northwest; in short, there are no slope concerns. 5. LOT LINE WAIVER: We request a 1 foot lot line waiver from the proposed drainfield to the west lot line. We are unaware of any adverse impacts with the granting of this waiver. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your M.S. NOTE: A site plan drawing, a design drawing, a detail drawing, a soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwc.com 11 II 11 II II II ' II 11 11 II ' MICHIGAN STREET ------------- SOUTH �i �CrEpnc '!aD —_ �I QI ol 0. i may! �� 3� ,�l Nf\\ \ ` Ji Zi I\\ r \ / 1 112TH STREET DATE; 6/20/2003 DRAWN BY: sem-- C.J.G. ALASKA WATER & WASTEWATER sGALE CONSULTANTS. INC. 1" = 100' 3101 F Tt" O040. SUITF 101' ANfNORAGF A% 00301' F NF 001131-01W ' FAX 00113�F3AM1 PREPARED FOR PHONE NUMBER: PAGE NUMBER;1..... .. .. .. ...... ....... . ....,si PHYLLIS do BRUCE JOHNSTONE 346-1575 1 OF 2 �: lett a A. Om B: Y LEGAL DESCRIPTION: tiy'4 Oi C —795 SOUTH LAKEWOOD HILLS: LOT 3, BLOCK 5 V�^s.e' •• .......... TYPE OF WORK: V^y ��pFofetsloWa.: SITE PLAN FOR SEPTIC SYSTEM UPGRADE 1 1 1 BIS. f I I SOUTH LAKEWOOD I I HILLS: LOT 2. BLOCK 4 I 1 \ I I PROPOSED SEPTIC UPGRADE I I (SEE DESIGN PACE 2 OF 2) I I�Pnc I I ARS � I 1 � f—i ��C ��11SOUTTI LAkEWOOD HILLS: LOT;. BLOCK 4 I I SOUTH LAKEWOOD 1 1 SOUTH IAI�EWOOD\\` SOUTH FlA10EWOO6 LAT 2j BLOCK 6 HILLS: LOT 1, BLOCK 6 1 I HILLS; -- r-- j I I SWTH LAKEWOOD 1 / I I HILLS: LOT 4, BLOCK B I •; I 1 r 'ISTWC I \` I sourH tAicE�v000 1 y� sEPnc I SYSTEM ��---` HILLS; LOT S, BLACK 0 1 ' I 1 1 SOUTH LAKEW6OD 1 HI115'1�0T 6. BLOCK 6 I I / ASEPTIC I � 1 I HILLS LOT e, BLOCK 4, ; I I \ I 1 I \ I 1 I I 1 \\ 1 1 SOUTH IAI�EWOOD\\` SOUTH FlA10EWOO6 LAT 2j BLOCK 6 HILLS: LOT 1, BLOCK 6 1 I HILLS; -- r-- j I I SWTH LAKEWOOD 1 / I I HILLS: LOT 4, BLOCK B I •; I 1 r 'ISTWC I \` I sourH tAicE�v000 1 y� sEPnc I SYSTEM ��---` HILLS; LOT S, BLACK 0 1 ' I 1 1 SOUTH LAKEW6OD 1 HI115'1�0T 6. BLOCK 6 I I / ASEPTIC I � 1 I UNE TO BE CAPPED FOR FUTURE USE NOTE: THL-MNTRACTOR SHALL HAV ALL WELL RADII SHOWN AND THE EXISTING DRAINFIELD TO BE FLOW WEST LOT UNE FLAGGED BY ABANDONED SG AS TO BEER REGISTERED LAND SURVEYOR. USED IN THE FUTURE ' aC�LDOL18LE OUTS— — — — — — — — — — — — — - 10' UTILITY EASEMENT -�----- -------------� SHED IF• 1 CARPORT INSTALL I c FCU?DATI 33 / LIT EXISTING SEPTIC TANK / THj1 / / TO BE COMPLETELY ABANDONED Io / �/ / PROPOSED 1250 GALLON EXISTING WELL SEPTIC \ I FLOW CAN NOT BE \ 1 ACHIEVED USE A 1500 1� GALLON S.T.E.P. TANK \ \\� INSTALL FLOW SPUTTER I \ — — - EASEMENT - TRENCHES PROPOSED DRANFIE DS. EXCAVATE 2 THAT ARE 9 FEET DEEP MAXIMUM BY 5 FEET WIDE BY 38 FEET LONG EACH (78 FEET I 1 I LONG TOTAL). ADD 4 FEET OF CLEAN, WASHED SEWER DRINROCK. INSTALL TRENCHES PARALLEL TO SLOPE CONTOURS. DATE: 6/25/2003 o O �p0 DRAWN Br: ALASKA WATER & WASTEWATER c•J.c. s �jE^ CONSULTANTS, INC. 5701 F TROAD. SUITE O 1Ol • AWHORAGF, AK 00507 • MF (0071557-0170 • FAX (007)358.3710 UOOR -30� �"" """y'o00 ' "' ' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PHYLLIS do BRUCE JOHNSTONE (907) 346-1575 OF 2 e e A ness: QOo o '•, C -7953 FO� LEGAL DESCRIPTION: LOT 3, BLOCK 5: SOUTH LAKEWOOD HILLS SUBDIVISION ••.• , �p e'e �co�d 0 feseLDOa �' �44p0000aa TYPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE O� ALASKA WATER & WASTEWATER L; yppp CONSULTANTS, INC. :.4 SOIL LOG - PERCOLATION TEST .... .......0 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS SUBDIVISION; LOT 3, BLOCK 5 Q a f y , ess.- ` 0 PERFORMED FOR: BRUCE AND PHYLLIS JOHNSTONE DATE -._6/16/2003 pp4u 7953 \�Op /ewe' •.. .••'�oo (feet)14 ORGANICS ITEST HOLE tflill 1 PAGE 1 OF 2 SOIL CLASSIFICATIONS 2 v o: SITE PLAN GW zzzz. ORG 3 MIXED GM/ML-+ GP 1 ML GM CL 4 GC OL °• •°= o SW MH 5 SP CH :51� SM OH 6 SC 7 DEPTH TO DATE MEGROUNDWA 8 DRY 6/16/2003 CRY 23 0 3 9 10 GM 11 12 13 14 15-10 B.o.1I. 16 17 18 PERCOLATION RATE 10 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 3.5 FT. AND 4.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: JOSEPH MARCHETTI COMMENTS: i PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W P FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: O DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 6/17/2003 , TER 1 2:57 - 6' - 2 3:27 30 3' 3' 3 3:27 Q 6' - 4 �L 7H%j�`� ` f / 3' 5 3:57 - 6' - 6 4:27 30 3• 1 2:57 - 6' - 2 3:27 30 3' 3' 3 3:27 - 6' - 4 3:57 30 3' 3' 5 3:57 - 6' - 6 4:27 30 3• 3' A ,ASKA WATER & WAS1'EWATLR o� —CONSULTANTS, INC. 0 ;, .. , SOIL LOG --PERCOLATION TEST LEGAL DES-�R"OTION: SOUTH LAKEWOOD HILLS SUBDMSION; LOT 3, BLOCK 5 PERFORMED FOR: BRUCE AND PHYLLIS JOHNSTONE DATE: 6/16/2003 DE °t n TEST HOLE 1 1 I L LLJ CD Q n 8 (n 9 O 10- 11 0 11 U LL_ 12- 13- 0 2 13 U 14- 15— Q 16 W 17 LLJ Cn 18 03110,011A .• .11. I� °- NET TIME (MINUTES) • 111111111 6/17/2003 - 31191 2:58 — 6- — H/NN•EMUI� 3:28 qTfa 2 1 2- 3 1/2 23 3 3:28 — 60 — 4 3:58 30 1 2 5/8* 8- 5 3/8' DEPTH TO DATE GROUNDWATER See PAce T OF ? 9 a AIIG s ss: C —7953 SEE PAGE 1 OF 2 FOR TESTHOLE LOCATION DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 6/17/2003 1 2:58 — 6- — 2 3:28 30 2 1 2- 3 1/2 23 3 3:28 — 60 — 4 3:58 30 1 2 5/8* 8- 5 3/8' 5 5 3:58 6- — 6 4:28 30 258- 338' PERCOLATION RATE 8.3 (MIN./INCH) PERC. HOLE DIA. c (lNChtJ) 19 TEST RUN BETWEEN 8.0 FT. AND 8.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: JOSEPH MARCHETTI COMMENTS: PERFORNCD BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: D_)) Municipality of.Anchorage Bttildiitg S.-&ctN Di%9siott George I'. 111ucrch, Mayor 6/26/2003 Jeffrey A. Gamess Alaska Water & Wastewater 6901 Debarr Road Suite 2B Anchorage, AK 99504 Subject: Waiver Request for South Lakewood Hills NI Block 5 Lot 3 Waiver Request #WR030049 Parcel ID #015-151-34 Dear Engineer: Anchorage All -America City IIIA/ 2002 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 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, (mac). �s✓t Jeffrey . Poet Engineering Technician On -Site Water & Wastewater Program P.O. Mx 196650 • Anchorage, Alaska f)<).519-6650 • Telephone: (!X)7) 343-E9301 • Fire: (tX)7) 343.82M 4700 South Braga«• Strect • Anchorage, Alaska Wi07 h It p://��w.ci.anch ornl;c.nlc.un Municipality of Anchorage Development Services Department '. Building Safety Division On -Site Water and Wastewater Program ` 4700 Bmgaw Street P.O. Boz 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343.7904 Waiver Review Worksheet WR#: 030049 PID#:015.151.34 HAM Permit#: Date Received: 6/26/03 Legal Description: South Lakewood Hills #1 Lor -3 Engineer: Alaska Water & Wastewater 6901 Debarr Road Suite 25 Applicant: Phyllis & Bruce Johnstone Waiver Requested: 1 Foot Lot Line from the Proposed Drainfleld to the West Lot Line Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: .................... ................................................ ..........r Waiver Is Granted: Il Waiver is not Granted., List Conditions or Reasons for above: Date: % — - O 3 By:�o- a Reviewer ........................................ ............................ ........r Rec#: 37619 Amount: $160.00 Date Paid: 6/2612003 Mi nicipality of Anchorage % Department of Health and Human Services 825 "L" Street George P. Wuerch. P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor htlp://www.ci.anhorageak.us 343-4744 August 14, 2000 Bruce B. & Phyllis A. Johnstone 1735 SE Elliott Portland, Oregon 97214 Re: Separation Encroachment of Absorption Field to Water Well, Lot 3 Block 5 South Lakewood Hills #1, P.I.N. 015-151-34 Dear Mr. & Mrs. Johnstone: The property described as Lot 4 Block 4 South Lakewood Hills #1 recently had the on-site wastewater disposal system and water well evaluated to obtain a Certificate of Health Authority Approval from the Department of Health & Human Services. The engineer performing the evaluation discovered that the water well serving the home on this property is being encroached upon by the wastewater system serving the home on Lot 3 Block 5 South Lakewood Hills #1. According to our records you are the owner of this property. The existing separation is 88 feet from your wastewater absorption field to Lot 4's water well. This water well is located across Magnolia Street to the west as shown on the attached site plan drawn by the engineer working on the approval for Lot 4. The required separation is 100 feet. This is a violation of Chapter 15.65 of the Anchorage Municipal Code of On -Site Wastewater Disposal Systems. The water well on Lot 4 was constructed in August 25, 1975. The trench extension off the seepage pit on your on your property has no documentation in our files. Without this documentation, this office has no alternative than to hold you responsible to resolve this encroachment matter. It is very important that you contact this office either in person or by phone at 343-4744 when you receive this notice. Please contact this office by no later than Friday, August 25, 2000. Sincerely, Daniel J. Roth Civil Engineer On -Site Services Program �•.8�21 Gf�"ER ANCHORAGE AREA BOROI' , O'cMARTMENT OF ENVIRONMENTAL QUALI,r 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 2798686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME e74NN ADDRESS /'Y/'3 7/t'/NSON St. PHONE, �3 %0� nnnF LOCATION OFF OM�7 �[A LEGAL DESCRIPTION–ZCT ,3 T3/A4 -S S lARfk�krQ /// SEPTIC TANK: NUMBER OF DISTANCE FROM WELL MATERIALCONL/P f.7F�fSa�nn_ LUZ� COMPARTMENTS K, LIQUID CAPACITY //oD/) GALLONS. INSIDE LENGTH '— INSIDE WIDTH — DEOPTH - SEEPAGE SYSTEM: SEEPAGE PIT NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH 17 , LENGTH 2 O , DEPTH 7 LINING MATERIAL e-- e, l?f%F PiNl-C �'? I. DISTANCE FROM WELL 119f?' , BUILDING FOUNDATION , G q NEAREST LOT LINE (J TOTAL EFFECTIVE ABSORPTION AREA (WAIL AREA) o z SO. FT. TILE DRAIN FIELD: DISTANCE FROM WELL , FOUNDATION , NEAREST LOT UNE_ NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH ABSORPTION AREA SO. FT. LENGTH OF EACH LINE TOTAL LENGTH OF LINES TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: DISTANCE FROM ��yy, WATER TYPE DEPTH / R ,BUILDING FOUNDATION&/�OTHER ��Q FO SAMPLE , NEAREST NEARELOT LINE �n �' .SEWER LINE ,TANKC�, SYSTEMSEEPAGE�, CESSPOOL SOURCES— LOT OF SYSTEM DISTANCES: /O'f f/u vS E 11P� e I �i 10 DATE / / APPROVED CZ�� ' , 4 � /' v G. .A.B. o. GRE,%rER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3500 TUDOR ROAD POUCH 6.670 ANCHORAGE. ALASKA 99502 TELEPMONE 279.6666 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT F7 �/ rhtO MAILING ADDRESS 4�a • '7 -KI k -SO ti\ Si' PHONE -313- -`' INSTALLATION LOCATION LEGAL DESCRIPTION 473 •" I �� 'IS vF' Vnrf, HWX S.L INSTALLATION OF: SEPTIC TANK I` SEEPAGE PIT /` DRAIN FIELD OTHER n D / TYPE AND SIZE OF FACILITY TO BE SERVED S UCY� SRu r/,- F-N/✓/r/4 A, FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS • NOTEI THIS PERMIT IS NOT VALID WITHOUT3GIL ZEST COMPLETION DATE ANTICIPATED FINAL INSPECTIONs_24 HOUR—NOTICEJIEOU IRE D. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ISNM TYPE SG•Jt. V'Ci E- oa-SACT" EEPAGE AREA SIZEV��st�; TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK J / FOUNDATION TO SEEPAGE PIT` DRAIN FIELD / / 5- / SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK Is— SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. SO %te)O WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. / WATER MAIN TO SEPTIC/TANK %r/ SEEPAGE PIT DRAIN FIELD �'y Sn SEPTIC TANK, SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP F EXOS FEET N Di03t. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITYr OR LICENSED DESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE 9 IS,171 APPLICANT'S SIGNATURE DIAGRAM OF SYSTEM O 26.68 AND THAT THE ABOVE Gt(EAI ANCHORAGE AREA BOROUGH f a t _ DEPARI_T OF EC'iIF.^N'1EN-'L 0A!.IT'.� CASE k 3500 TUDOR ROAD ANCHORAGE, PLASKA 99502 Performed For John Odde Date Performed 9/28/71 Legal Description: Lot Block D Subdivision S..Lakewood Hills This Form Reports Soils Log x — Percolation Test Depth Feet 2 .L 4- 6- 8- 0-3- 2— �I Tan sandy silt 2 SO Gray & brown silt -sand mix ._.-....._. _. aso Gray silty sand Sand with fine gravel Was Ground Water Encountered? no °� If Yes, At What Depth? Reading Date i I Gross Time Net Time ;Depth to H2O i I i Net Drop I I ' � t t I Was Ground Water Encountered? no °� If Yes, At What Depth? Reading Date i I Gross Time Net Time ;Depth to H2O i I i Net Drop t I rui LuIa6�win na L'e Flu to Proposed Insta ation: Seepage Pit x Drain Field Depth Of Inlet Depth To Bottom Of Pit r Trenc COMMENTS: —' 217 square feet of drainage area is req it d per heAronm with thp crih er from 3 to 12 feet deep. esF Fe-rTo-rmed BYR. E. Carlisle Vata Certified y NATIONAL TESTING SERVICES, INC. Date- f �E 27'X (o` ._ �{ 07 /81x18x9' y71' RECEIVED OCT 4 1971- Phi OEtAtlll ANCHONACi ARIA 1010W*M DEPT. Or 1NylRQNM{NIAt OOAlltt Municipality of Anchorage 1 Development Services Department Building Safety Division On -Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL �1 FOR A SINGLE FAMILY DWELLING Parcell.D. 015- 1151- 3y, COSA# fl(c CGu� 1. GENERAL INFORMATION Expiration Date: - 06 Complete legal description Location (site address or directions) 11101 MAGNOLIA STREET • ANCHORAGE. AK 99516 Community Class Well ❑ Current Property owner(s) DAVID LoBOUNTY Day phone 770-5442 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 11101 MAGNOLIA STREET • ANCHORAGE. AK 99516 GREG MOORE w/ PRUDENTIAL J.W. Day phone Day phone 762-1897 3801 "C" STREET • ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 . 3. TYPE OF WATER SUPPLY: Individual Well E Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site N Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, UD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lost, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local sor7s condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Date 0 (� Conditional approval for bedrooms, with the tllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory L/ Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other •,4 —Ar.I-S{TE WATER AND •: :—VaA3fiEWATER PROGRAM ' By: Original Certificate Date: a— 16 —D6 (P- TIMI Municipality of Anchorage Development Services Department Building Safety Division OnSke Water b Wastewater Program ' 47W Bragaw Street P.O. Box 1988.50 Anchorage, AK 995196650 www.muni.orglonstle (907) 943-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SOUTH LAKEWOOD HILLS S/D #1: LOT 3. BLOCK 5. Parcel ID: D /S- / S/ - 3 y A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1971 Sanitary seal (Y/N) YES Wires property protected (Y/N) YES Total depth 178 R. Cased to 40+ R. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 1/20/2006 OG Static water level O 1� R. 102 R. N Well production g.p.m. 4.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 oolonies/100 ml. Nitrate 0.1 mgJL. Other bacteria 0 colonies/100 ml. Arsenio <5.0 ugJL. Data of sample: 1/20/2006 Collected by: GEG. Ltd. S. SEPTIC(HOLDING TANK DATA Tank Type/Material STEEL Date installed 7/2/2003 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation dearrout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 11/22/2005 Pumper AROUND THE CLOCK C. ABSORPTION FIELD DATA POELOW EXISTING Date installed 7/2/2003 Soll rating .p.d r ft'/bdrn) 0_8 System type SHALLOW TRENCH Length 76 (2 O 38) R. Width 5 R. Gravel below pipe 4.0 ft. Total depth 9.42-9.42 It. Eff. absorption area 760 R' Monitoring tube YES Depression over field NO Date of adequacy test 1/20/2006 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 8/a in. Water added6�6 gal. New depth 12 in. Elapsed Time: 1 BO min. Final fluid depth 2L7- kr. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N S type) NONE KNOWN If yes, give date "TESTED NORTH DRAINFIELD D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. "Pump o�aFet--�n. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animai excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ' i p Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingtvehide storage 1' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 'WAIVER GRANTED #WR030049 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and e'. 4 ❑ s 't review of Municipal records that the above systems are in • • "" •' ..• • • • •' •' • • ..• ... conformance with MOA COSA guidelines in effect on this date. ey Gornem.: Engineer's Printed Naa JEFFREY A. GARNESS 9 �! TT 7t 3 r�' '•,;,l�ob •'c` Date edprolenaod COSA Fee S q30 Waiver Fee $ _ Date of Payment V 7-1 (5� �� Date of Payment Receipt Number en Kkt Receipt Number. (Rev. tarot) T t4 A I rq y` P$y yyrfiS lin � �m P y SN � N1 fQ y QEE�yg� Z TTy E 133HIS VI-IONE]VW N O°051 00" W 160.o0 5 09135'00"E 160.0 off•'°"• `°Sj�4p� vim' •''• ••:9 1� E__A, �� SG9 SCS ReEH 1060343001 All Dates/Times are Alaska Standard Time Client Name Gayness Engineering Group, Ltd. Printed Date/time 01272006 8:16 Project Name/N South Lakewood Ilills Collected Date)Time 01202006 13:15 Client Sample ID South Lakewood Ilills L3 D5 Received Dateffime 01202006 16:17 Matrix Drinking Water pi Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Paramcltt Results PQL Units Method Container ID Limits Date Date Init Nitrate -N 0.100 U 0.100 m8/L EPA 353.2 D (<=10) 0120/06 JC Metals by SCP/MS Arsenic 5.000 5.00 ug/L EP200.8 C 0124/06 0125/06 WAW Microbiology Laboratory Total Coliform 0 coU100mL SM209222D A (<=q 0120/06 TLF ays Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 www.cf.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ParoeII.D. ` I�j_ �5HAA#_. -.J O3Q904 1. GEN'ERAC INFORMATION Expiration Date: Complete legal description SOUTH LAKEWOOD HILLS #I P LOT 3, BLOCK 5 Individual Water Storage ❑ Community Class Well Location (site address or directions) 11101 MAGNOLIA STREET * ANCHORAGE. AK 99516 Current Property owner(s) PHYLLIS do BRUCE JOHNSTONE Day phone (907) 346-1575 Mailing address SAME Lending agency Day phone Mailing address Real Estate Agent LARRY SUITER Day phone 273-7766 Mailing address PRUDENTIAL VISTA • 4241 8 STREET • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. ;TYPE OF WATER SUPPLY: 0 Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by odea/ affixed hereto and as of the validation date shown below, Aenfythat my investigalpe nfti don procedures outlined in the Health Authority Approval Guidelines for this application, show Mal the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered of the time of the test, and separation distances measured to readily Identitable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the wafer usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory fest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for Lf— bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist 1/ Septic System Advisory Well Flow Advisory Phone 337-6179 Date 16,42 bedrooms, with the tllowing stipulations: Manitenance Agreements Supplemental Engineer's Reort Other WOE u •Trn AAlr% WASTEWATER - PRAPRAIA By�, Original Certificate Date: 10-3-03 (Rev. 12,01) Municipality of Anchorage Development Services Department �J Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196850 Anchorage, AK 99519-86W www.ci.erchorage.ak.us (907)343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST # I ort Legal Description: _ SOUTH LAKEWOOD HILLS: LOT 3, BLOCK 5 Parcel ID; 654-151-34 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 1471 Sanitary seal (YM) YES Total depth 178 ft. Cased to 40+ ft. FROM WELL LOG Date of test Static water g.p.m. WATER SAMPLE RESULTS: Well Log (Y/N) NO Wires propedy protected (YIN) YES Casing height (above ground) 20 in. AT INSPECTION 7/17/03 109 ft. 4.7 Coliform 0 colonies/100 ml. Nitrate 0.1 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: N/A mg./L. Date of sample: 7/17/03 Collected by: AKWWC, INC. B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 7/2/2003 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper - C. ABSORPTION FIELD DATA Date installed 7/2/03 Sod rating ,p.d. ft'/bdrm) 0_8 System type SHALLOW TRENCH Length 76 ft. Width 5 ft. Gravel below pipe 4.0 ft. Total depth 10'+/- ft. Eff. absorption area 760' eft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test _ in. Water added _gal. _in. Elapsed Time: _min. Final ft ' _ in. Absorption rate >= g.p.d. At ion treatment (past 12 mo.) (YM 8 type) If yes, give date D. LIFT STATION Date installed "Pump on" level at _in. Datum E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm 8 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption fteld on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank 100 + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line $11 Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 1000+ Driveway, parking/vehicle storage 1'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and a a review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. . .... r.A rass.... Engineer's Printed me JEFFREY A GARNESS () o _79 Date 17pror s.on' � ��4poa� HAA Fee $ 3'15: t L50 = 45A5.O0 it Waiver Fee $ _ Date of Payment Date of Payment Receipt Number 14,2573 Receipt Number (Rev. 12/01) 7-26-03; 6:26AM; SGS Ret# 1034378001 Clieat Name AK Water & Wastewater Consultants Inc. Project Namel# Lakewood Hills Client Sample (D Lot 3 Blk 5 11101 Magnolia Matrix Drinking Water ;907 5615301 Ali Datti/Times are Alaska Standard Time Printed DateMme 07/24/2003 13:28 Collected Date/time 07AW2003 8:27 Recelved Date/lime 07/172003 12:10 Technical Director Stephen e Released B� 0 B- 2 �I Sample Remarks EP 300.0 - Sample was run past hold time for nitrate. )7 Andysis Parameter Qualifiers Results PQL Unite Method Container ID Limits Allowable Dne Dale Init i Waters Department Nitrate -N 0.100 U 0.100 mg/L EPA 300.0 B (<-10) 0721/03 JIB Microbiology Laboratory Total Coliform 0 col/100mL SM189222B A (<=1) 07/17/03 JS MAENA'Al'" uw i . ..uu.su„u a I O•untm [A•EMCHT s 00-09t M ,00 ISOoO N MAGNOLIA STREET w� J a�g Hai m W. Hw b a S �:p S� �g�gw a �ZLL ffoa EFS WZ�WN uZi uw i . ..uu.su„u a I O•untm [A•EMCHT s 00-09t M ,00 ISOoO N MAGNOLIA STREET w� J a�g Hai m W. Hw b a S �:p S� �g�gw a �ZLL ffoa EFS WZ�WN i GREATER ANCHORAGE AREA BOROUGH �UIV Department of Environmental Quality jl�" 3330 "C" Street, Anchorage, Alaska 99503 274-4561 ^/ Date Received Time of Inspection r Date of Inspection %3 Ull, REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES ✓� c ,"� r �" „FOR d( ccr 1? -/, 71A X/7 1. Approval requested by: 71C�. atm. x �� ti/,-✓ %47 > Mailing Address: Y(J• 6� 7/�1�0— Y9s A7,1- 2. Property Owner: yea c �, plc c11�,c.-.//�/ Phone: Mailing Address: Lay" e+F• � I 3. Legal Description: �1L� n<.�,�� 4. Location: K� cw.-.-•L.. ✓ /C j 6. 7 Type of facility to be inspected Well Data: / ,)of bedrooms 5`- A. TypeB. Depth C. Construction D. Bacterial Analysis Sewage Disposal System:14.4� 0 A. Installed ,O<,r is -7i B. Installer C. Septic Tank: 1. Size /c�-^-c 2. Manufacturer D. Seepage Pit: 1. Absorption Area %' 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank 73 , Absorption area / Sewer Lines Nearest lot line ",i Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages r� Page 2 of two pages - Req.est for Approval of Individual .er & Water Facilities -regal DescriptionaT Comments /d7r"'L--e�6..-'-. 4 r- .. cJ � (. Z A -r e, Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to De a true anG accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74)