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SAND LAKE #2 BLK 4 LTS 5 6 47 & 48
and Lake #2 Block 4 Lot 5,6,47,48 #011-135-55 Municipality of Anchorage Development Services Department Yf - Building Safety Division On-S4e Water and wastewater Program, 4700 S. Bngaw SL P.O. Box 196650 Anchorage, AK 89516-8650 Page of m,r ci.anchorage.sk.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO40365 PID Number. 011-135-55 R.m. John & Pat Forbes Wastewater System: [D New ❑ Upgrade Aeeaaaa 8042 Seaclift St. Anchorage, AK 99502 ABSORPTION FIELD flno 2435169 Nmworeaeowrla 3 ODaap71.2nQen.a. rbr<n Qs.e❑Mane Qom.r LEGAL DESCRIPTION SM RMV 0.8 onOli TOMo.an� p5 GPD,R fl. back LOC euom ft 4 5,6,47,48 Sand Lake #2 D" M PP rasion nan onaral abet +f- 7 Gm OapnM pas 7.5 R R 7a 4' Range 9.cbm Fn a00u0 sews aprel¢W Gr Larplh 2 R. 38 R. Well: ❑ New El Upgrade G a a wm. 2 Rbnea aan.a 1 Dwa as Whwn. Na pL R R clatlaxaran (Pr"ab, A, e, C) Tpbl Dapm caaaab TMIa PWie,. Pp Mt C 321 R R 570 R' 4'raaraL sewLf PI L- Draer Dub Dna SMW WM LMl 1 a w Dam. xa <1971 155 R John Forbes Nov 7.9. 2004 YenPbnpsa9. GNnDWOAAooreGranO TANK GPM fl. 2 R SEPARATION DISTANCES Aseptic ❑Holding QS.T.E.P. E3 other To Septic Absorption Lit Holding ICIPrnate a aO w 1=4 From Tank Field Station Tank Sewer lire Greer 1500 Gal WaL 158' 162' rda n/a >100' Mahal Steel NMoo.rur Conpnnam 2 a., nYft r >100D' >1000' Na rVa LIFT STATION Lott." 15' 10' n1a n/a n/a ow n/a FelMamn 84' 121 n/a n/a v,mPpn'a. A Na p Para a Na Mqn wuaraarnn Na h in h cbbn Orale n/a n/a n/a n/a 7 a MneM a.aNe E a ve na pa a n.O W 1,113 Na R" ft There are no public/private sewer lines or surface BENCH MARK water bodies In the vacinity of this system. The following LoolM arM Dacrx.On Comer lot gne and building k)cabon based on 2004 upgrades were added to the well on Lot 47: Pitless MM Ft as -built survey conducted by Lantach (attached) tt115' Adapter, well casing extended 24" above ground level, relocate pressue tank to house, installed new sanitary seal. t Kell B. Leseman P.E. M Nov 7, 2004 Inspections performed by: Y Dates: 1 ••• ••••• •iy •• � 2rd Nov 9, 2004• . ................ Developm t Department Approval �p .�Lr . SEMAN erylce I� CE -9591 Reviewed and approved by: 4l Date: 8 �� �� fp'•.. ,,..•'`E`' •� ca.. txoo) �1�''ROf[SS111`1p -r NDP 5DA I I tj 4a) . tiP��•OF •AC�S,�I Air • H Of F•• ... ...i KE f IS. LESEMAN • ; v ,�Ilq'• E-9591 sePREPARED FOR: JOHN & PAT FORBES 8042 SEACLIFF ST. ANCHORAGE, AK 99502 i PERMIT N0. SW040365 i SAND LAKE SUB DIVISION NO.2 LOTS 5,6,47, & 48, BLK 4 WORTHE"lOwner DWG NO. REV cox @IILTSITE PLAN Renee M. HignPalmer AKALE 1- 70' SHEET 10(2 Proposed DraiK�aa E,<otw iwo Trencn« / \ Dne that It 17.5 Feet Lanq, The OIAw ZO / \ r«I Lmq Both Ar. Ios rw of Chan. / \ wosned Sews. Dro+voca. Nfldl 1.25 PVC / Wln rHd« O ISS On CMIeI / / YUIM Double deanaub / LOT aq, BLOCK SANG LAKE S/D R i Eeialnq _ _ •. Bedroom / E.�slnq Sepik 7oµ �e G.neYMntss raA� I 4E.isting ponTMd FAh MoA (Aeonaanw) - o � Prapoaeallsooga KJ�L aafi` / Sepik let,A � ❑ � a � r � `3' PRiaa To coNSTRucnaN THE 7 � EwsTwc TEST HOLE WAS / �w°T+o'u�K°EOs`/o R EXCAVATED ar�u o70caouNow°;¢RTaR \ BEDROCK. CLASS C WELL SERVES LOTS 7, , d aB O LOT 43. BLOCK 4 SAND LAKE S/D R 1 \ Foundation Cleo. Out Cleo. Outs O 45' . r^ ze • KEt 18. lESEMAN •v 1500go1 Septic Ton,,�• VI ���JS;• E-9591 �•V��. Dee,, Trench Nater. 2' W.de 38' Lengln 14♦ Deep Double Cleanout 7.5' Sewn Rock 6' Cover 22 1- Bend Clean Out Monitoring Tube Cleon Out Monitoring Tube 115• It Borrie k Insulation nsulation 108.5 _ 108.5 108.7 1101.0 e o oa oa �s ha s� Q.86 V Y „O 3u Su —� PREPARED FOR JOHN & PAT FORBES t' 8042 SEACLIFF ST, AK 99502 ANCHORAGE, u,. �• PERMIT NO. SWG40365 a+i;. SAND LAKE SUB DIVISION NO.2 LOTS 5,6,47, & 48, BLK 4 BIOATIIEAlf TRAILS Dwo NO. C O w s V LTI N a PLAN AND PROFILE Renee M. Hignutt, Owner SCAU N.T.S. SHEET 2 of 2 Palmer, AK REV 30' 3' ROW TAKING PER WARRANTY DEED, BOOK 25! PAGE 384 1 30' o cam. OF.AZ`q,� 0 49TH •.�* ...✓i........................... •• STEVEN CALLAGHAN.-' a ' LS -12034 �� ���� Of essiono� o W F 0 250 H Street Anchorage, Alaska 99501 Survey Department Phone 562-5291 y"��in Inc Mainline Phone 243-8985 Aum AECC 668 ORDERED BY: HILARY LOCKHART NOTES: 1. THIS DRAWING SHALL NOT BE MODIFIED FOR USE ASA PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. 2. LOTS 47 &48 ARE SUBJECT TO A WATER SERVICE LINE EASEMENT PER BOOK 45, PAGE 250. 3. THE LOTS 5, 6, 47, AND 48 ARE SUBJECT TO AN INGRESS/EGRESS EASEMENT PER DOCUMENT NO. 2005-062127-0. 0 O 0 LO O O 6 LO • 30' 30' W W H N LL LL_ J V Q IW 4. THE LOTS ARE SUBJECT TO THE FOLLOWING BLANKET EASEMENTS: 5. CHUGACH ELECTRIC ASSOCIATION RIGHT OF WAY EASEMENT PER PRECINCT BOOK 70, PAGE 325. 6. CHUGACH ELECTRIC ASSOCIATION ROW EASEMENT PER PRECINCT BOOK 69, PAGE 105. LEGAL DESCRIPTION: AS -BUILT ADDRESS: 8042 SEACLIFF ST. PARCEL #: 011-135-55-000 pp LOTS 5, 6, 47, 48, BLOCK 4, & LEGEND: SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE SAN D LAKE SUBDIVISION N0.2 SEPTIC SS (1) STANDPIPE .. Asphalt . , , , :.: PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST WATER WELL (1) Concrete GUY WIRE Overhang UTILITY POLE � Wood Deck FENCE X -X-1.-.--- - l OVERHEADSHOULD ELECTRIC--oHE-- ROW f aking OTHER THAN NOTED. EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCE OFANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES. DRAWN DATE: 9-23-2018 WORK ORDER: 18134 DRAWN BY: AP PLAT: P-176 CHECKED BY: SC GRID: SW2224 SCALE: 1 " = 30' FB/PG: 811/38 REF: 04L164A John and Patricia Forbes 8042 Seactiff Street Anchorage, AK 99502 907-143-5169 Fax 907-334-3325 Phirmazci.net September 6, 2005 Daniel Roth Municipality of Anchorage On -Site Water and Wastewater P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: Owner installed Septic System on Lot 5, Block 4, Sand Lake S/D #2 Dear Mr. Roth, I would like to advise On -Site that: 1. I am the owner of Lot 5, Block 4, Sand Lake Subdivision #2, Parcel ID 011-135-55. 2. On 10/15/20041 installed a septic system under On -Site Wastewater Disposal System Permit # SW040365, using Garness Engineering Group's soil testing, site plan, and design for the septic system upgrade, dated July 6, 2004 (on file with On - Site) with the following exceptions: A. I used a larger Greer 1500 -gallon septic tank with 2 compartments. B. I used a more durable 4 -inch DriscoPlcx PW4100 PE 3408 SDR 11 High Density Polyethylene Pipe (IIDPP), which meets or exceeds the standards set in AWWA C906 and ASTM F714 for the clean -outs, and monitoring tubes. The IIDDP is more durable, stronger and flexible than the 4 -inch ASTM 1785 PVC 1120 SCH 40 pipe in a cold weather environment, in case of a lawn mower or snow blower collision. C. I used the existing indoor foundation clean out, which is easily accessible from basement. 3. 1 used 4 inch SDR 35 PVC Perforated Pipe in the deep trench drain field. 4. I used 1%- 2 inch sewer rock from AS&G in the deep trench drain field. 5. The entire installation, from start to finish, was supervised and inspected by a State of Alaska Registered Engineer, Kelly B. Lescman CE -9591. J n Forbcs 1I meowner For more information and technical assistance contact: �e�r Performance Pi pe, a division d tr/edp ,1. " Chevron Phillips Chemical Canparry LP D je7irV �./[ P.O. Box 269006 Plano, TX 750269006 800.527.0662 DriscoPlex° PE 3408 HDPE Piping Systems Municipal and Industrial Applications and Standards Typical Markets for Pipe and Ftttinge FMA Approved Undorground Fire Main Mining Perforated Pipe Water Distribution Municipal & Industrial, Water Distributit Sanitary Sewer & Trenchless Rehabilitation TreatedlRedaimed Water Industrial Sewer, Municipal Sewer, Slipiining & Trenchless Rehabilitation Industrial Specialty NOTICE. Capabilities vary from manta availability of D3lticutar shoe or shell a 1. IPS sizing system. 2. FMR Approved Gass 150 or Class 20D in 2'.24' IPS pipe 3. A s irgle "tudinal color stripe is extruded !colo it* pipe 00 to identify DR. 4. Various perlcration patterns are available. 5. DIPS sizing system. 6. The DIPS longitudinal Odor stripe pattern is three equally spaced pairs of cola stripes extruded into the pipe OD. 7. Blue odor stripes are standard. A due Cola Shell is available on special order. 1500 Pipe 1600 Pipe Pipe Pipe four equally spaced single color stripes extruded Into the pipe OD. 9. Green cola stripes are standard. A green cola shell is available on special order . 10. Red cola stripes standard. 11. Purple cola stripes are standard. A lavender color shell is available on special order. 12. Solid light gray color. 13. Light pay color 8mtg extruded into pipe ID. 14. Factory assembled casing and carrier. 15. Green color stripes are standard. 8.9 5.6.9 8.11 5,111,1111 1,12 5.6.12.15 1,13 5.13 1.16 standard. 17. FMR & NSF Approved Clam 150 or Class 200. Blue coke stripes stanxlanl. 18. FMR Approved Class 150 or Clam 210 in 4'• 24' DIPS pipe Sim. 19. Black is sum l rd Dim color stripes or blue color shell available on special order. 20. Y IPS and 3' IPS me& to ASTM D 3035, AW WA C901 and NSF 61.4' IPS and larger mole to ASTM F 714, A W WA 0906 and NSI 61. Bulletin: PP 109 Revision Date October, 2002 Aedie Nat1'padltkaa Before using the piping product. ft user is advised and cautioned to make its own dolermination and assessment of the safety and suitability of the piping product for the specific use in question and is further advised against relying on the information contained herein as Chevron may relate to any specific use or application. it is the ultimate responsibility of Bee user to ensure that the piping product is suited and the information is applicable to the users specific application. This data sheet provides typical physical property Information for polyethylene rosins used to manufacture Use piping product. It is intended for comparing polyethylene piping resins. It is not a product specification, and Phillips does not establish minimum or maximum, values a manufacturing tolerances for resins a for the piping product. These typical physical p sionokod plaques prepared from resin. Values obtained from tests or specimens taken property values were determined using canpresn ikes"I GYaaF Y from the pping product can vary from these typical values. Performance Pipe does not make, and expressly disclaims, all vraranties, at Moo" tic merchantability a fitness for a particular purpose, regardless of wRwther oral a wntten, express or Impiied, a allegedly arising from any usage of trader a from any course of dealing in connection with the use of information Contained herein or the piping product itself. The use expressly assumes all risk and liability, whether based In contract, tort or otherwise, In connection with the use or the information contained herein or the piping product itself. Further, information contained herein is given without reference to any intellectual property issues, as coo as federal, state, or local laws which may be encountered in the use thereof. Such questions should be investigated by the user. For more information and technical assistance contact Perromwnce Pipe. a division of Chevron Phillips chemical Company LP P.O. Box 269006 Plano. TX 75026-9006 800.527.0662 DriscoPlex° PE 3408 HDPE Piping Systems Typical Material Physical Properties of DriscoPle)P HDPE High Density Polyethylene Materials Dai P Material Designation — ASTM F 412 PE 3408 Cell Classification — ASTM D-3350 345464C (black) 345464E color Density g/cm3 ASTM D-1505 0.955 (black) 0.947 color Malt Index g/10 minutes ASTM D-1238 0.1 Flexural Modulus psi ASTM D-790 > 130,000 Tensile Strength psi ASTM D-638 3200 SCG (PENT) hours ASTM F-1473 > 100 HDB at 73.4"F (23"C) psi ASTM D-2837 1600 Color; UV Stabilizer — ASTM D-3350 Black with minimum 2% carbon black Color, UV Stabilizer — ASTM D-3350 Color with UV stabilizer Linear Thermal Expansion inch(nch/°F ASTM D-696 9 x 10.5 Elastic Modulus psi ASTM D-638 110,000 Brittleness Temperature -F (°C) ASTM D-746 <-180 (<-118) Hardness Shore D ASTM D-2240 65 Members Of: Bulletin: PP 109 Revision Date October, 2002 kdow"Pr►rLrfkrs Before using the piping product. the user is advised and cautioned to make its own determination and assessment of Ute safety and suitability of the piping product for the specific use in question and is further advised against relying on Ute information contained herein as �V/1A may relate to any specific use or application. U is the ultimate responsibility of the user to ensum Uel the piping product is suited and the Chet// Information is applicable to the user's specific application. This data sheet provides typical physical property information for polyethylene rn resins used to manufacture Ute piping product. It is intended for comparing polyethylene piping resins. U is not a product specification, and /� Phillips does not establish mmaximumn or maximum values or manufacturing tolerances for resins or for the piping producL These typical physical property values were determined using compression -mo ded plaques prepared from resin. Values obtained from tests of specimens taken 6aq Y [kirry from the piping product can vary from those typical values. Performance Pipe does not make, and expressly disclaims, all waranties, of N lVw&,k lmm merchanlability or fitness for a particular purpose, regardless of whether oral or wniten, express or Implied, or allegedly arising from any usage of trade or from any course of deakng in connection vAth the use or information contained herein or the piping product itself. The use expressly assumes all risk and liability, whether based in contract, tort or ottermse, in connection with the use of the information contained herein or time piping product itself. Further, information contained herein is given without reference to any intellectual property issues, as we as federal, state, or local laws which may be encountered in the use thereof. Such questions should be investigated by the user. Welts:9 O 0 Well Information -Well log not available Date: LAS #: L 15 0log Source of information: p w U;&z Information provided by / Owner name: Well location (MTRS): S QL, 12, , 4 - 10 QC a 6 a- �1 1 Property description: 5 PPJD L& k � 2, ALV C1 , ti fs 5 6. l�T18 Well depth: 32 t ft Static water level: 1 155 ft Stickup: ft Type of well: Yield: gpm Is well capped? Date drilled: G 7 Drilled by: 4-g,>K,. P", Diameter of well: in. Is it a bedrock well? Depth to bedrock: ft Cased? , to ft Screened? , from ft to ft Perforated? , from ft to ft and from ft to ft. Use of well: Any comments on well? k0gu- oP L97 VS. Cd,fe.x 400 5?�c�yP � "��9N1� •se-Q:s �+i�ww 42.4,0.x_ TANIr R�waDu� 097^�0 -3,ri c k u P— j5 S .�F� -,v A f r Asavjf e -4A- D yr DQ 1 Ci i N AcIY A U,ft "C w L24 C S _ n-040 2a ri sti " R� QLD t,t� �4 r,yr✓ 1 y 8�� (i� 4, Sketch of well location and/or construction: 0,-C_ W ICtl 40 A?,q J9R.^ AM S A Sig J pF 00" Mg -if -414 Y v 6.5 CLU s 7 N.F OPP7`V 3 be 6k. !s ,¢C76c A «Y -32 1 -f� ,IR C -AV l�2s� 8�. - 1 � � �,,•� w»h+ IS�a (JR,�c�Qo�v � 5� ��4 f C-. rwr,,9c �9Tr cTF GdNS,�cKG'7r►p,J �,..NxNo��. Fs-�.�,,��i0, Nae: 71iran abwdd br signed byes Col((tedlssbAer, Projavloas7Gginar, DECas$. ere OwaedUdldrr AU iesraoryrtenoaa mmimADECpfaseppovdpfwma vwdm Sn18AAC80Staeq(A1=La Drmkm2Marr Regrdadw Jar rOerUk rep Wresesu. , STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION DOCUMENTATION OF CONSTRUCTION Mw Received GENERAL1. N M N Legal Description of the Location 15A1Jf7 TACE :SID ft LO4, 5t&,47 T y8 Submitted by: (Check ooe) O Certified Installer 0 Approved Homeowner Id Registered Engineer ip 1OfX el Installer Name:`` __ LESEMAro P.F.C S&. MMa01SC/J Onsite Wastewater System Serves: Qq Single Family. Numberof Bedrooms 3 O Duplex. Number of Bedrooms O Small Commercial Facility With Estimated Design Flow of less than 500 GPD. Mailing Address IZ441 "DAA DQ, /,N f�P—t AK 99 S 15 11. WATER SUPPLY SYSTEM SECTION 11 IS OPTIONAL) Swore of Water and Cotwmma (Clerk all tlnt Apply) ® Well (Dri fed ar Driven) O Surface (ldesljy) ❑ Roercadancra ❑ ludins Ta do ❑ Other (ld-40 ype of waxy sappy sypem ❑ SFMwL% ❑ Public Tmmxn of Water (Check all that Apply) ❑ None O Chlorination ❑ Filtration O Minnal Removal ❑ Other: well Data Is the Ixiala of dw yell caring owe the 12• above dx roure.1 Em Ya O No Is a unitary vel or well cup installed on the well es W, M •Yes ❑ No Is draimpe directed may from or wound the casimtwhhin a radius of 10 fed of the wellcasing. ® Yea ❑ No 4 well wve enclosed in c nduirr 10 Yes ❑ No <Dril ed e11 Oepdh3 Z ell fPeep Swic Wlhnd level (eery Yield (U available) Phmhp Rax (((available) ion Diaance frwn the Well Casing seach of the Followi sources ofCawwninrtim: Sepuc/lloldiog Tan[ on LO Feet Sewer Line on Lot Feet Absorption Am on Lest Fed Ckrsea Sepuc/lLokhnx Tank on Admonk Ld Fen Ckaet Sewer lima on Adiama let Fat Cktac t Floe of an Absorption Am on Ad'aem Let- Fed IMi use separation duunce frown sac a uenals hchding fuel ranks, pauws, hrhricaes and other kum bardm ierids, irides or Mbicides swell casin on 1 nt Feet Ort Adiacent 1 At Feet Water Sample Taken by: (Name) Sampler 6. L! Gayer ❑ F.ngiac O Banker O Gwemmnp Official Address Water Samnle Resulls: Attach Com ❑ Satisfactory - DateO ser 'sf - Date Commenw'Recommendations: ACoeo toq(IS}tNy Well, P1{1es5 (AJc e4ejAl 4P_Y,4 -J Well Castny 2y at A60ue jjlradel r00ceq4-wta1 pr'sSLA+'e 44v\14 40 C%0`5ae 1 1n53k,11e,c] AeW 54v11+Ari See, l Sigrooue -�--�1&1�1 "fyped'Prined Name 8- Title Gate Nae: 71iran abwdd br signed byes Col((tedlssbAer, Projavloas7Gginar, DECas$. ere OwaedUdldrr AU iesraoryrtenoaa mmimADECpfaseppovdpfwma vwdm Sn18AAC80Staeq(A1=La Drmkm2Marr Regrdadw Jar rOerUk rep Wresesu. ILL WASTEWATER DISPOSAL Legal Deseriptiom L&4s 1/6 16 .1 f" Type of Wastewater System: gj Septic Tank with Conventional Soil Absorption System ❑ Package Treatment Plant (requires engineered design) ❑ 11olding Tank: Material Type: Siu in Gallons: Manufacturer. O Other- Specify Type ❑ Alternate Onsite (requires engineered design) O Small Commercial System (< 500 GPD) With Estimated Daily Wastewater Flow of: Gallons Per Day (GPD) Criteria Used to Estimate Daily Wastewater Quantity: NEW SYSTEM O REPAIR TO EXISTING SYSTEM Certified Installer Installation Notification Date•. Name of lnstaller: t6SEMAM PLE - MARLK,nes Date Installed: 10/11 tat System Installed: By a Registered Engineer O With Inspection by a Registered Engineer O By Approved Homeowner attach copy of approval letter) Q By a Certified InstallcrMstaller Number Septic Tank: Material: Manufacturer. Size(Gallow): Number of Compartments: 1 00- 5^1 Type of Soil Absorption System: Qi DecpTrench ❑ Shallow Trench O SeepagcPit ❑ Bed ❑ Mound O Other, Specify Soil Classification: CqPIS P Soil Rating-, Dimensions/Size of Absorption Area: % . S ; Gradin iu of Distribution Rock: % 1%I r,4tWAr 20CV, Thickness/Depth of Distribution Rock: •7• S Percolation Test Results, Attach Copy of Report: PercolationTest Performed by: •'/. G ^rw rcS by Minute per Inch. R bedroom - tE�i� mrAc ed enp. List ground cover in feet over. is Tank Absorption Area Sewer Pipes Clcanout Pipestcaps Installed: I FoundationClcanout: Z Septic Tank: •/ MonitorTubcs: Indicate separation distances from septic tank or absorption area, whichever is closest, to all nearby: Public drinking water sources within 200 feet Private drinking water sources within 100 feet: Nearest water bodice see 18 AAC 72.020(b)): Lot line: Separation Distance from Onlot Sewer Lines to: Public Drinking Water Sources: Private Sources: Separation Distance From Bottom of Distribution Rock to: Groundwater Table, Bedrock: + e. A Separation Distance from Absorption Area to Slope exceeding 25% W43 Sttl e Comments/Recommendations li NtW upils C.aNNttied 4-z exly4tut( l.twg APp/b�u•an q.r6l..l 20:1 f rowr 41(tS: OF inoa SE• E:xI5.t•N5 rro"s JOL440•• Cjt4no"4. MQl� {4M Cd, 1 certify that the above information and that movided in Section IV is correct: Signature Typod/Printel Name Title, RegJCert No., Inst. No. Date +•i1�1 D DSS NOTE: Nmrbesq WbyaC. fwd lxmUa.Prvfwkw l£J,guzft AV.V gSe.ra...,pmfed...�, 413X, ^ rrgtrrmdm wwM. a.d irNgwet dwt blods wed.m be mw .RD.enP6revad • irf v Stw1 •.i Rrgue Ewginee fo.at o *�YI /� / ii - •� V. 1PIPLXi am VC DIa I LIvl(: INSTRUCTIONS FOR DIAGRAM 1. In a plan view, locate and k1cmiry each of the following: a) Well b) M Shuctunes e) Surtax Water o Sacmorcontammation h) Closest well on adjacent property )j Closest edge of an absorption field on adjaxnt property C) Septic Tank d) Soil Absorption System g) Property Line (lwlyde dimensions) i) Closest septic tank on an adjacent property k) All elearauts and monitor sobs 2 Show distances braween the well and each of dace sauces of contamination listed in 1. i. Show distaaces between water bodies and each part of the onsite system listed in 1. 4. In a cress section view of the soil absorption area, identify each eomponant and show the depth (thickness) of the following: a) Soil Cover b) Absorption Material c) Water Table d) Bedrock e) Discharge pipes f) brsulation 5re AAAc(neo Er y^,tArer%S ri.e�,� ani Ai I 1:13a1s 3-4nOV3s — �—� _ i ® Z— o0 os �unos 00 -os OJ HI "< 1 tr 1•- 1 o 1 : z a u i Gv 5 N I "C3 n 0 to 0 CIE Coll 0 RD Lr) o •• ♦ Go 00 z •!/��, N " ;oto rzr 36.2 to R r r N F S N �•�p= W= N �✓ el ycr'Sttil� '9 s'si e i ,00.OS �Z �2y O=i S j ?M2 br � �nlo1��pop��opporyyoy�� �a F� ,�ool�oo W L / o w J=� L Q• b) I a a0 pOo 0co 1N�^0 o ss• '� � Y 1 F Wg W tl _ N U v ! 4 zp ! so -^6a 4 .00.09 Ninos )'OS HiaON .00'0s F aN9� 0 0 N .5 c0 Sy+ v iVfl; i LdSe�c KI I i v w Ln OJ to p 1 tr 1•- 1 o z a u U v ! 4 zp ! so -^6a 4 .00.09 Ninos )'OS HiaON .00'0s F aN9� 0 0 N .5 c0 Sy+ v iVfl; i LdSe�c KI nY- I fly 4.•• ..,�•! w , Municipality of Anchorage Development Services Department • '� Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Kelly Leseman/John & Patricia Forbes Legal description: Sand Lake Subdivision 712. Block 4. Lot 5. 6. 47 d 48 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ® Discrepancy in information submitted. Please verify pipe size ❑ Topographic information missing or inadequate. _ ® Incomplete; missing copy of recorded easement. accuar ® Incomplete; missing location of all wells and wastewater disposal systems within 200 feet of property ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ® Other. It appears system was installed too deep. Design required lift station installation. Name of reviewer: Julie Makela, P. E. Date: 1/10/2006 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage Development Services Department • Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orgtonsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Kelly Leseman/John & Patricia Forbes Legal description: Sand Lake Subdivision #2. Block 4. Lots 5. 6. 47,A 48 The attached paperwork has been reviewed and is being returned for the following reasons: ® Original signature or stamp missing on all documents ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. _ ❑ Topographic information missing or Inadequate._ ® Incomplete; missing absorption field monitoring tube, post -tank double opposing cleanouts. foundation cleanout ® Incomplete; missing scaled site plan showing all features described in Sections 15.65.050 ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ Name of reviewer: Julie Makela. P.E. Date: 8/25/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Permit Number: SWO40365 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 9951M650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Aug 27, 2004 Expiration Date: Aug 27, 2005 Parcel ID: 011-135-55 Legal Description: !SAND LAKE #2 SUBDIVISION BLOCK 4 LOT 5,6,47,48 + Design Engineer: 0855 Garness Engineering Group, LTD Site Address: 8042 SEACLIFF STREET Owner Name: JOHN & PATRICIA FORBES Lot Size: 26850 SO. FT. Owner Address: 8042 SEACLIFF STREET Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99502 - This permit is for the construction of: Q Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be eiiher: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: g Issued By�- Date: 5, Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 61/- 136- 55 Permit Number Property owner(s) JOHN do PAT FORBES Day phone 243-5169 Mailing address (1) 8042 SEACLIFF STREET • ANCHORAGE. AK Mailing address (2) Zip Code 99502 Legal description (Lot, Block & Sub'fl SAND LAKF S/Q2: LOT 5.6.47 k 46. BLOCK 4 Legal description (Section, Township & Range) _N/A Lot Size Z, 955 Acres/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and Is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. Permit Fees: "f%o • UU t"� a56D Date of Payment: Receipt Number. I IS Waiver Fees.. 115 -Cb Date of Payment: 11slo Receipt Number. NU GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS July 6, 2004 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System upgrade for Sand Lake Subdivision #2; Lots 5,6,47 & 48, Block 4. To whom it may concern: The existing 3 -bedroom house is served by a private well and septic system. The septic system is failed and must be replaced prior to the sale of the house. One test hole was excavated on the property. The drainfield will be designed around the 30 -foot radius of this test hole. We are proposing that a new 1250 -gallon step tank and a deep trench type drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 0.6 gallons/day/R2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 7.3 minutes/inch b. Proposed Application Rate: 0.8 gallons/day/R2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 562.5 RZ f. Total Depth: 10.5 feet (max.) g. Effective Depth: 7.5 feet h. Width: 2 feet i. Reduction Factor: N/A j. Minimum Length: 37.5 feet long total k. Effective absorption area = 562.5 RZ 3. SURFACE NVATERS: 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: gamessengineering.com 4. TOPOGRAPHY: The average topography in the area of the proposed drainfield is relatively flat. In short, there are no slope concerns. 5. LOT LINE WAIVER: We request that your department issue a 1 -Coot lot line waiver from the north property line to the proposed drain field. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. 6. JUSTIFICATION FOR SYSTEM DEPTH: The total depth of the soil log is 14.5 feet, with no groundwater or bedrock encountered. However, we are proposing the total depth of the field to be 10.5 feet deep. During construction we will excavate the existing test hole to a depth of 16.5 feet to confirm bedrock or impermeable soils are not present. I am 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 NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log, 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 0 Website: gamessengineering.com 07/02/2ooa GARNI:SS ENGIN? G F CONSULTANTS GENERAL DRAWN BY: - �!•' V1 I ' fes:' G GROUP, Ltd.scu.E: M.E.W � 9 '••. �y1, 17A, F T1Fb0 OOAO 5OTK 101 . Awmophl:c AK OOSA7 . Wnw f0 r ..K -70. FAX (01711\A.ANA 1 — 100, PREPARED FOR PHONE NUMBER: PACE NUMBER: � JOHN & PAT FORBES 243-5169 1 OF 1 •.J f Go es LEGAL DESCRIPTION:4P 953 SAND LAKE S/D #2; LOTS 5,6,47,48, BLOCK 4 ��;°/ '••. ,..••'����' TYPE OF WORK: y,AT4-up•o(saalo"o\ SITE PLAN `4Rrzz0;; LLJ g I W. BOTH AVENUE I / _---- 2 WELL 1 jh6 uT' mEs 1. I I %1 I '` 2&3 Q EP \\ I PROPOSED STIC `3 I ' ' 0 SERVES TS UPGRADE SEE PACE 2 ` \ OF 2 FOR DETAILS EXISTNC THREE i i1 `I� I `t BEDROOM HOIUSE _- -_ , '3 I , ,•�� I -.'_' --4 ,-c c W�EpLL RADIus ?VFS 1 11,76 i 0 WELL 7 ryj �.4 6 ' 6 CLASS C SERVES LOTS 7. S. 45 & 48 ,' - �L - �_ W i '1 8 ' 7 I O __-- __----'b cn 1 �` / �- 8 ' �1,Vo uTI s 1 \ NOILrnLmES/' I V ,S0.5Em'��Fs ciC / \ 10 12 0 41 11. I , 1 1 07/02/2ooa GARNI:SS ENGIN? G F CONSULTANTS GENERAL DRAWN BY: - �!•' V1 I ' fes:' G GROUP, Ltd.scu.E: M.E.W � 9 '••. �y1, 17A, F T1Fb0 OOAO 5OTK 101 . Awmophl:c AK OOSA7 . Wnw f0 r ..K -70. FAX (01711\A.ANA 1 — 100, PREPARED FOR PHONE NUMBER: PACE NUMBER: � JOHN & PAT FORBES 243-5169 1 OF 1 •.J f Go es LEGAL DESCRIPTION:4P 953 SAND LAKE S/D #2; LOTS 5,6,47,48, BLOCK 4 ��;°/ '••. ,..••'����' TYPE OF WORK: y,AT4-up•o(saalo"o\ SITE PLAN `4Rrzz0;; LOT J. BLOCK 4 ND SAND LAKE S/D /2 A REGISTERED LAND SURVEYOR PRIOR TO ANY NSTRUCRON: NORTH �E PROPOSED DRAINna DS„ EXCAVATE TWO // LOT �S � LINE TRENCHES. ONE THAT IS 17.5 FEET LONG, .150' CLASS C WELL RADIUS LOCATED ON LOT 7, BLACK THE OTHER 20 FEET LONG. BOTH ARE 10.5 FEET DEEP ANO 2 FEET WIDE WITH 150• CLASS C WELL RADIUS LOCATED ON LOT 2 BLOCK 7.5 FEET OF CLEAN, WASHED SEWER DRAINROCK. INSTALL 1.25- PVC WITH / 1/4- HOLES O 15. ON CENTER DOUBLE WAIVEERR REDVESTED I LOT 49, BLOCK 4 \ \ CLEANOUTS i —I — \ T _ SAND LAKE S/D #27. / • \ \ 0 / �,•a~, T7HHEEEE �}�? ' ••' S i �`; \ BE�DRTINGI HOUSEµ - EXISTING SEPTIC TANK BE •�;:-: \ COMPLETLY ABAONDO � C EXISTING DRNNFIELD TO BE I fff///�fff COMPLETLY ABAONDONED \ El PROPOSED 1000 CALLON STEP TANK. TO CONSTRUCIIO EXISTING TEST NO LL BE 1 (�Q , �l!���.,/�v TO / TO EXCAVANO GROUNDWATER LOT 7, BLOCK 4 vJ Q' SAND LAKE S/D /2 CONFIRM OR BEDROCK. CLASS C WELL SERVES LOTS 7 8 45 A 48 \ LOT 46, BLACK 4 SAND LAKE S/D 12 r _ 7L- LLOT LOT8, BLOCK 4 SAND LAKE S/D 12 LAT 45, BLOCK 4 \ \ SAND LAKE S/D /2 \ / LOT 9, BLOCK 4 LAT 44. BLOCK 4 \ SAND LAKE S/D 12 SAND LAKE S/D 12 _ DATE �pdop 7/2/2004 oa OF 0� , ,... 4 DRAWN BY. G _ .. ..._.._ GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS I GENERAL CONTRACTORS I1n o *T q Ste: 3701F TMOR ROAD S111TF 101 • ANCHMA4FM. AX 00507 - PHF (907)511-6179*PAX1001UM-371M1 -40r �,,,,, ,,, ,,, ,,,,,, ,,,,, PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JOHN k PAT FORBES 243-5169 1 OF 1 O p .Je re A. GG SS.: O Q . '•, C -79 •' .`p LEGAL DESCRIPTION: AND LAKE S/D #2, LOTS 5,6,47 do 48, BLOCK 4 �0OF �P• o\�ovo X11 I'S�� TYPE WORK: UPGRADE DESIGN OF A SEPTIC SYSTEM GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 7701 WPA 7 101 • ANOCRY E A H007 • 007)W -.17S • AA: F N • VMM' ,•,r.gY-.YpmO SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: SAND LAKE SUBDMSION /2; LOTS 5,6,47 & 48; BLOCK 4 PERFORMED FOR: JOHN & PAT FORBES DATE; 6/28/2004 ((r ai� �M TEST HOLE Al ...... Tr 1. 7T W. `....... ...(farnessr 79 3- :Z • NapK- ... 'Ale TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ROB CAMPBELL COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ORG SOIL CLASSIFICATIONS 2 GW ORG GP ML SP/SM GM CL 4 •.__ • • GC OL ••J:•:• °. •°0 o SW MH 5 •::•: t' ;• SP •:.•. t SP CH •� J•••• SM : OH �•''�'• •'• SC SEE ATTACHED DESIGN DRAWING 6 7 '�?`= DEPTH TO DATE GROUNDWATER 8 GP DRY 6/28/2004 9R ♦�` 7 SITE PLAN 1'-100' 10 `+rte•: •, ••"'� CLOCK NET TIME WATER LEVEL NET DROP DATE READING TIME (MINUTES) READING (INCHES) ': 6/30/2004 1 5:40 — 6' - 12 .•. .�...�. •'•• SP 2 6:10 30 1.5' 4.5' 13 : ;� 3 6:10 - 6' - • • • 4 6:40 30 1 7/8" 4 1/8- 8'14 14-0-000 0.0; 5 6.40 - 6' - 6 7:10 30 1 7/8- 4 1/8- 8'1516171819 8.0.11. 15- 16- 17- 18- PERCOLATION RATE 7.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19— TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ROB CAMPBELL COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: A A s K A Q la 2005-0621.27-0 Recording Dist: 301 - Anchorage 8/31/2005 11:03 AM Pages: 1 of 2 Ingress/ Egress Easement Grant made this 2,(,_ day ofA 2004, between John Forbes, 8042 Seacliff St. hereinafter referred to as the Grantor, and 94ohn Forbes, 8042 Seacliff St. hereinafter referred to as the Grantee. Whereas, the grantors are owners as tenants in the entirety of the following described realty: Sand Lake #2 Subdivision, Lot 5, 6, 47, 48, Block 4, according to the official Plat # 176 in the Anchorage Recording District, Third Judicial District, State of Alaska, And, Whereas, the grantees are desirous of enjoying the use of a certain portion of the grantor's land for the sole purposes of ingress and egress to Grantees land for the purpose of maintaining a private septic. And, Whereas, the grantors have agreed to grant to the grantees as easement solely for said defined purposes and for no other, Now, this grant witnesses that in return for said specified consideration the Grantors hereby grant to the Grantees, there heirs and assigns, full and free right to maintain a private septic upon a portion of the Grantors land. This Grant of Easement is intended to be appurtenant to Grantees above described land and touches, concerns and runs with said lands. This is not intended to be an exclusive easement: The Grantor herein expressly reserves unto themselves equal rights of ingress and egress and all other rights as the owners as tenants in the entirety of the described premises. Any dispute or disagreement arising under or in any way concerning this instrument shall be submitted for resolution to the process of binding arbitration in accordance with the Alaska statures made and provided for said arbitration. The jurisdiction of the Arbitrator shall commence 60 days form the onset of the dispute and shall operate to toll all applicable Statutes of Limitation. 3701 East Tudor Road, Suite 101 • Anchorage, Alaska 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengincering.com 2 In Witness Whereof the Grantor and Grantee have above written. State of Alaska ) ) ss. Third Judicial District) set their hands the day and year This is to certify that on this -alL day of 2004 before me the undersigned, a Notary Public in and for the State of Alaska, duly c issioned and swom, personally appeared John Forbes, to me known to be the persons described in and who executed the above and foregoing instrument, and acknowledged to me that they signed and sealed the same freely and voluntarily for the uses and purposes therein mentioned. Witness my hand and official sea] the day and year in this certificate first above written. L Notary Public in and r Alaska My Commission expires Z rl?laufn VO.. 8o1Az � 2005-0921274'1 3701 East Tudor Road, Suite 101 • Anchorage, Alaska 99507 Ph: (907) 337-6179' Fax: (907) 338-3246 + Website: garnesscngineering.com T I 'F MASS ] I N I � ; E DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER PROGRAM http://www.state.ak.us/dec/deh/ August 5, 2005 t' t FRANK A MURKOWSKI, GOVERNOR 555 CORDOVA : ANCHORAGE, AK99501 Phone: (907)269-7696 Fax: (907)269-7650 mailto:Vanessa Blevinsnadec.state.ak.us File: Sand Lake Subd #2 FI. Frank Cahill 880 N. Street Suite 203 Anchorage, AK 99501 Re: Operational Denial Class C water system serving Lots 5 &: 6,47 &s 48 Block 4; Sand Lake Subdivision #2 Dear Mr. Cahill: On July 29, 2005 we received your fax regarding the water system located on the above referenced property, currently owned by John and Pat Forbes. Mr. and Mrs. Forbes submitted a "Class C" well registration application to this office on June 6, 2005. A required component of the registration packet is a waiver approval from the Alaska Department of Environmental Conservation (ADEC) for any separation distances that do not meet minimum state requirements. Although they signed the registration form indicating that all separation distances were met, our files indicated that separation distances were not met and the requested waivers had been denied in 1988. This waiver denial resulted in the compliance order by consent that you referenced in your letter. At this time, we cannot proceed with the Class C well registration process without addressing the public health risks associated with any inadequate separation distances. Additionally, it should be noted that ADEC has delegated the authority over private septic systems to the Municipality of Anchorage. I have enclosed a copy of my recent letter to Mr. Forbes regarding this situation. If you have any questions, please contact me at the above number. Thank you, Wv� Vanessa Blev s, P.E. Environmental Engineer cc: Dan Roth, Municipality of Anchorage, Onsite Water and Wastewater Program, PO Box 196650, Anchorage, AK 99519 �.,�,� Printed on Recycled Paler LAW OFFICES OF H. FRANK CAHILL 880 N Street, Suite 203 Anchorage, AK 99501 (907) 2224905 • FAX (907) 274-8201 e-mail: cahili@gci.net July 29, 2005 VIA FAX to 269-7650 Original mailed Vanessa Blevins Environmental Engineer Alaska Department of Environmental Conservation 555 Cordova St. Anchorage, AK 99501 Re: John and Pat Forbes Class C water system, Sand Lake Subdivision #2 Dear Ms. Blevins: Rec'ety p AUG - 2 2005 rADECI o;; Orage en h Hiyfth I represent John and Pat Forbes, the owners of a single family residence located on Lots 5, 6, 47 and 48 in Sand Lake Subdivision #2, Anchorage. The subdivision, created about 1950, consists of a number of relatively small residential lots, each about a quarter -acre or less. Unfortunately, this is an area that has not been served with public water or sewerage, and the residences there are all served by on-site water and wastewater disposal systems. The Forbes' property has a well, located on'Lot 47, that serves both the Forbes' house (which straddles Lots 47 and 48) and another property located on Lots 50 and 51. This well was drilled no later than 1971, and, pursuant to a recorded easement dated 1975, must provide water to the property at lots 50 and 51. This easement will terminate only when the house on Lots 50 and 51 can be connected to a public water system. In 1983, the Municipality of Anchorage, either with or without acquiescence from the DEC, approved a septic system on Lot 46, neighboring the property now owned by the Forbes, and within 85 feet of the well on Lot 47. This appears to be a violation of the minimum separation distance required under 18 AAC 80. There is no reason to think that the owner of Lot 47 had any role in the placement of the septic system on Lot 46. In or about early 1988, the DEC filed an administrative action against Robert Kowalke, Vanessa Blevins July 29, 2005 Page 2 who then owned Lots 5, 6, 47 and 48. This action resulted in an agreement between Mr. Kowalke and the DEC (Compliance Order by Consent, #88-2-14-084-1), fully resolving concerns that the Lot 47 well/class C water system lacked source protection and an operating certificate, and operated in violation of AS 46.03.020(10), and 46.03.720, and the DEC regulations pertaining to those statutes. Kowalke agreed to disconnect service to Lots 50 and 51, and obtain MOA approval for a private water system by September 30, 1988. However, Mr. Kowalke did not do so, and apparently no action to enforce the agreement was brought against him.' ' Moreover, and most critically, the:DEC'did not record the compliance agreement so that it would be noticed to any purchaser of the Kowalke property. In 1992, entirely without notice of any deficiency in the water system, the Forbes purchased the four -lot parcel from Kowalke. They were, of course, on notice of their easement obligation to lots 50 and 51. No action to enforce the Kowalke compliance order has been taken in the intervening 13 years. In 2005, the Forbes applied to the MOA to license a bed -and - breakfast on their property, and were first notified by DEC of its objection to the license and to the deficiencies in the water system. The problem confronting the Forbes is not unique to these properties; it appears to be a general problem throughout Sand Lake #2 Subdivision, and will only be fully corrected by the installation of public water and sewerage, but the private parties in this matter have no control over that. The problem here resulted from the installation of a septic system on Lot 46 when the well on Lot 47 was already in place. This was not the responsibility of the Forbes, nor of their predecessor in interest. Even if the Lot 47 well is made a private water system, the septic system on Lot 46 is still too close for legal separation (85 feet). The fix should be the removal of the Lot SS'septic system (or its conversion to a closed discharge system). -The hardshipto the owner of Lot 46 can be mitigated by some payment from the agency that improperly authorized the installation, or by payment from the person who applied for the installation, or both. If one of the two (well or septic system) has to go, it would be neither more efficient nor more fair to remove the well than to remove the septic system. The owner of Lots 50 and 51 has a legal right to enforce access to the water well on Lot 47, and could sue the Forbes if they deny him access to the well. Alternatively, assuming that testing reveals no bacterial contamination and no excess nitrates, the DEC could simply withdraw its objection to the existing situation and to the issuance 'Indeed, given the existence of the legal rights created by the water easement for the benefit of Lots 50 and 51, it was not possible for Kowalke to comply with the agreement. Itis unclear why the DEC would have suggested such an agreement without involving the owner of Lots 50 and 51. Vanessa Blevins July 29, 2005 Page 3 of a bed -and -breakfast license, pending the eventual installation of public water and sewerage. v3w H. Frank Cahill MUNICIPALITY O` ANCHORAGE e MEMORANDUM n„o To From: M 19 Re: Lots 5,6, 47, 48 Sand Lake Subdivision #2 The well on this property is, also, serving another lot(Lot 50 Block 4 - trailer sits on this lot). There is an agreement between the two parties and it is recorded that they share the well and maintain upkeep on it. When public water becomes available, then Lot 50 Block4 must connect to the public water supply and disconnect from this well. Also, back in 1971, the legal description was picked up incorrectly to obtain the on-site sewer permit. The sewer system is in reality on Lot 5 Block 4 Sand Lake Subdivision #2 and the well is on Lot 47 Block 4 Sand Lake Subdivision #2. The applicant picked up the tax code number of the property #48 in the circle, probably thinking it was the lot number. So this needs to be changed also. Beth from Busy Bee Realty, 278-4685 has researched and pulled all this lovely information. She wants us to recheck still approved with this has been receivedt.9ned 91-015 (Rev. 1/81) and make sure this is new information that Laura GAAB-HD-' GF -"SER ANCHORAGE AREA BORO! DEPARTMENT OF ENVIRONMENTAL QUALIT> 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279.8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME_ MAILING ADDRESS PHONE LOCATION �/--- i v_L LEGAL DESCRIPTION SEPTIC TANK: ��jj /// \ -- b � 6D%b�C 4 r I Y i DISTANCE FROM WELL -__ IyUMBER OF �� r MATERIAL , < `% _COMPARTMENTS LIQUID `' "" LIQUID CAPACITY GALLONS. INSIDE LENGTH INSIDE WIDTH-DEPTH- IDTH DEPTHSEEPAGE SEEPAGESYSTEM: SEEPAGE PIT: NUMBER OF PITS _ r - OUTSIDE DIAMETER OR WIDTH /`� LENGTH DEPTH LINING le, X'7 I' ��1 MATERIAL < <7 DISTANCE FROM WELL I BUILDING FOUNDATIONff' , NEAREST LOT LINE / '' /f- TOTAL EFFECTIVE ABSORPTION AREA (ALL9REA) �>�� / SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL ""` FO -DA-TtQN NEAREST LOT LINE OF LINES , NUMBER OF LINES_ DISTANCE BETWEEN LINES TRENCH WIDTH IN. OTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE - DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL• , TYPE 41- DISTANCE FROM WATER DEPTH BUILDING FOUNDATION.— SAMPLE NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE SEWER LINE , TANK / --� SYSTEM / /! , CESSPOOL , SOURCES_ DISTANCES: I Critl Xk_ %' DIAGRAM OF SYSTEM DATE 21 'ISAPPROV'�E���...�.-`---- G.A.A.B. GREA I ER ANCHORAGE AREA BOR UGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. l / 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT MUS -464 /1� MAILING ADDRESS ! �PHONE , INSTALLATION LOCATION .�l41'L'� - L-11-1 LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK �SS.� SEEPAGE PITA DRAIN FIELD OTHER , TYPE AND SIZE OF FACILITY TO BE SERVED S Ad1v mle FINANCED THROUGH Tr BE INSTALLED BY bW Gi/%f, � 1 CcC✓Ud'�' �/� SOIL TEST RESULTS ✓ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE oO! r TYPE �`�-®' SEEPAGE AREA SIZE we MINIMUM DISTANCES, REQUIREMENTS � FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT , DRAIN FIELD ` SEPTIC TANK, SEEPAGE PIT©® DRAIN FIELD , TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 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. J HEALTH AUTHORITY ,per OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED (STEM IS IN ACCORDANCE WITH SAID CODE. DATE � / /PPLICANT'S SIGNATURE ' _ l AuQUACY REPORT +.T� { = �,, A!_5 iLTI.6 QUA LIT YCO!.rTRD: -------- ---- - — ----- - - — -- - --- - --- -- - -- -- - - - D- 81-1597 4 Cltvelond Ave. 710 Third Ave July 21, 1981 REPORT FAT 5rx 10-1126 P.O. Boz 2540F :roinpe,AK. 99511 Foirbonks,AK..99707 7- 0231 452 -12 67 • 456-5155F TEST July 16, 1981 LEGAL DESCRIPTION : LOT55.6.47-, BLOCK_, __.SAND LAKE IT SUBDIVISION 48, OR-__ SECTION_-__ T_ N, R- _W, S.M. , ALASKA PERFORMED FOR: WES HILLMAN 8283 SAND LAKE ROAD ANCHORAGE, ALASKA 99502 Pr J!: E NO 243-5448 TYPE OF SYSTEM. XXX SEPTIC TANK - SIZE XXIX CRIB OR SEEPAGE PIT E3 LEACH FIELD NUMBER OF BEDROOMS 4 SEPTIC TANK WAS PUMPED IXX$ES 0 NO AESORPTION RATE: AVERAGE 24 HOURS 600 GALLONS SURGE RATE' 480 GALLONS IN 48 MINUTES. NOTES 8 OBSERVATIONS: REQUESTED SY_ NO. GALLONS Alp or °•° i% *;foio� O's ° ........ ....°sees... .. sees.. �94 Q ♦ 3 Kinney R. Ba ter 3656 - E vis o DAY 1 DAY 2 DAY 3 TANK CRIB TANK CRIB TANK CRIB Initial 84 3/4" 72" 84 3/4" 54" 85" 58 1/4" 480 83 5/8" 58 1/4" 78 1/8" 25 1/2" 120 surge -- -- 76 1/2" 23" TEST PERFORMED BY: T. B. REPORT PREPARED BY: _UIIN BRAUN APPROVED BY: K1NNEY RiBAXM,PE 24- Y 0/1-/31-42 r03� 1011-131-.405!41 3.3.71, //OW PAIV)T or O// /3 % Oy" DEL ETE-O (1?O41vYAY) �Sr9f f- 9XOI,CO /2-30-741 361 (jc��j 6D1��211 ra @ O r z3 C) U 03 _ C O C> C) Ci - CD 0 _ O C Cleit. V 01 CD P _ 'Z012- L3LK $� C G �� r -`.' 0 (0� CD r � 0- /� 0 0 J /) - --._()rte- �\ 0 _ G. 7 Cr ) 01 C\ l J ; - /p CJ �� y�iv ' I ,.K Y 0/1-/31-42 r03� 1011-131-.405!41 3.3.71, //OW PAIV)T or O// /3 % Oy" DEL ETE-O (1?O41vYAY) �Sr9f f- 9XOI,CO /2-30-741 361 (jc��j 6D1��211 ra @ O r z3 C) U 03 _ C 6111) C> C) 1 C - CD 0 _ O C V 01 CD P _ 'Z012- C) C G �� r -`.' 12 r � 0- 0 0 - 1 Y 0/1-/31-42 r03� 1011-131-.405!41 3.3.71, //OW PAIV)T or O// /3 % Oy" DEL ETE-O (1?O41vYAY) �Sr9f f- 9XOI,CO /2-30-741 361 (jc��j 6D1��211 ,9 1-14- 09 E t C� ra @ O r z3 C) U 03 _ �� C3) /G C� 1 C - U D_ _ O C C) 0 _ G. 3/ 01 C\ l J ; ,9 1-14- 09 E t C� ra @ O r z3 C) U 03 _ O °'J /G C� 1 C - U D_ _ O C IN F2]-- -- -- G -- O i7 C z . C� Z' O � G-1 (✓ rl0,91 0 —. �, n C� 22 z , / 0 —. �, z/C) j 22 /G 23 26 25 ? 13 _ ¢ /J rldjoin,ng Poge No. Adjoininq Tax Book No. O q� a1 P" a J -F kn Y 33 L� J � 4 a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES ) DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 3SS7/ v) 2S - LW q Application Date ✓ rl / S ( z �J 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include-ot, block, subdivision, section, township, range) Z' Location (address or directions) 5G'//� Szc/'/'?�' (b) Property Owner ��` F.7ur��4 Telephone: Home Business�Z--.,) --STI-7 Mailing Address ' FO//Z 1;{ (c) Lending Institution �br � ° Telephone �Z'q —��� b Mailing Address ;60I" (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followina address: or: Check here, if hold for pick up. List contact person and day phone number below. f5s^p '2 �'3 — g-yo-� 2. TYPE OF RESIDENCE Single -Family, Number of Bedrooms _ MUN�pNTA O ANCHO,RA FNV/RO F RV/CFS DI GE �PR )s�8 3. WATER SUPPLYRETE! Individual Well 11 Community Public ❑ ED 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 ❑ Community ❑ Holding Tank ❑ 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 (Rev 8/861 Front 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 watersupply 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 4 e S . �� Telephone SZ 0 Y O Address /,200W> 3 r c Ji—� S C3 -717f_03 Date �Lp.� / S ` />Y -- -- +►°'' av` "v +� y•o co•a r � O O 'f 00 _ _ -T L�•tvOT• o l O..i9• • •YY i.•••••••••••pc 4 I➢ „• tP 0Y C. REID, JR. 4 ?aa '.' CE - 2251 �e �� r e't 0eaoval �`� a DHHS APPROVAL ,.�q) Approved for 1` bedrooms byDate A eyed- 4D sa Conditional Terms of Conditional Approval. ex Tint ? clews ss � j'0/ lf8fl dhhs CAUTION l The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates 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 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 (Rev a as) Back ggPICIPALITY OF ANCHORAGE (MOA) MUNtCIPA 1V OF ANCH D"WH AUTHORITY APPROVAL (HAA) ENYA�SERVtCES CHECKLIST- FEBRUARY 1984 gNViRONI/ 264-4720 6 19B Legal Description: A. WELL DATA 'E1v t® Well Classification C_ If A, B, C, D.E.C. Approved A) Well Log Present (Y/ 1))Date Completed 4'�'f /`i?/ Yield Total Depth ? 2/ Cased to z/O Y Depth of Grouting Static Water Level / �_S_ Pump Set At — Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Sanitary Seal on Casing (9N) Depression Around Wellhead (Y/VO. To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line /4 -'One To Nearest Public Sewer Cleanout/Manhole N n4 To Nearest Sewer Service Line on Lot Water Sample Collected by A , e I ; Date 3 3048' 2 - Water Sample Test Results Ya,7L " A)E-Ir,,fie r '. a (AY02 Comments B. SEPTIC/HOLDING TANK DATA fvo4v Date Installed 1!Z 7 / Size IP61 0 No. of Compartments Z Standpipes ON) Air -tight Caps &N) Foundation Cleanout (Y1I� Depression over Tank (Y/6P Date Last Pumped -Zs a acfs'� Pumping/Maintenance Contract on File (Y/N) 1-,14 ; for H Holding Tank High -Water Alarm (Y/N) 2V "g Temporary Holding Tank Permit (Y/N) N 4 Separation Distances from Septic/Holding Tank: r To Water -Supply Well 1�2 7 To Building Foundation To Property Line 3�' To Disposal Field l� To Water Main/Service Line Course '> /00/ Comments Page 1 of 2 72-026(11/84) ? 2-0 To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata .Samar d Type of System Design Gr DoT i Date Installed 9/6/7 Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present (QN) Depression over Field (Y10 Date of Last Adequacy Test Results of Last Adequacy Test 142L`Jz Separation Distance from Absorption Field: To Water -Supply Well To Property Line y To Building Foundation f / To Existing or Abandoned System on Lot �A� ; On Adjoining Lots Z -0-Y, ' To Water Main/Service Line 5:227 To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course Nj /�L To Driveway, Parking Area, or Vehicle Storage Area //0 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 nimoncinnc / Manh /// 19 le/ ss (Y/N) mp Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA 4* Check Permitted Bedroom Rating Against HAA Request " I certify that I ha checked, verified or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ? Date ���/� OF A4j"�(giik ,!� �� .� 4p 0499nppp F Company MOA No. �A,' .6 pp U.:f- Coss f- 9 C, ,o ' H o aY t�3 Receipt No. bCF Zl jo; eo° 000 feea 0694009 ess� Date of Payment 44 d� , ffR / �2R�SAmount: $ A 06 e 00 CE -2251 a6Ar14 0 Of 6604,64 Page 2 of 2 72-026 (11/84) CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order # 5854 Date Report Printed: APR 4 88 8 09:42 Client Sample ID:LS, 6, 47, 48, B4 SAND LAKE #2 Client Name AECS PV±SID :UA Client Acct AKECSRP Collected MAR 30 88 09:30 hxs. P.O.# NONE P,EC'D Receiye6 MAP. 30 88 ? 14:30 hrs. Req # Preserved with :11011E Ordered By Analysis Completed :APR 1 88 Laboratory 3uperyisox STEPHEN C. EDE Released By --- ----------- Special Instruct: Chemlab Ref #: 9522 Lab Smpi ID: 1 Parameter Tested ------------------------------------------- NITRATE-N Sample ROUTINE SAMPLE. Renrks: SAMPLE COLLECTED BY LEE REID. Matrix: Water Send Reports to: 1)AECS 2) Result/Units Method ---------------------------------------- ND(0.10) mg/l EPA 353.2 Allowable Limits --------------------- 10 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION PIS 61988 ECEI\/fD 1 Tests Perfoxmed See Special Instructions Above UA=Unayailable 'ID= None Detected See Sample Reu:axks Above NA= Not Analyzed LT=Less Than, GT=Gxeater Than rte, p Ag STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 DATE: April 4, 1988 PWSID: Class C Well To Whom It May Concern: According to the records on file in this office, the Lots 47, 48, 50 & 51_, Block 4, SAND LAKE #2 Subdivision Water System satisfactorily meets State of Alaska Drinking Water Regulation, 18 AAC 80.040-080. Please note that subject system has been issued a Compliance Order by Consent (attached), which limits this system to operate until September 30, 1988. At such time, the water system will be converted to a private water system. If you have any questions, please contact me at our Anchorage/— Western District Office. NPL: pkk Sincerely, Michael P. Lewis Environmental Engineer MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION R 61988 RECEIVED 1 2 3 4 S 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 II ) BEFORE THE STATE OF Al )KA DEPARTMENT OF ENVIRONMENTAL CONSERVATION ALASKA DEPARTMENT OF ENVIRONMENTAL ) CONSERVATION, ) Complainant ) vs. ) ROBERT KOWALKE, ) . ) Respondent ) ------------------=------------------) Compliance Order # 88-2-1-4-084-1 .COMPLIANCE ORDER BY CONSENT The Alaska Department of Environmental Conservation (hereinafter "Department") and Robert Kowalke (hereinafter called "Respondent")$ are desirous of resolving a disputed matter over a water system (hereinafter called "water system"). It is therefore agreed that: 1. The water system is a Class "C" Public.water system on Lots 47, 48, 50 & 51-, Block 4, Sand Lake #4 Subdivision, in Anchorage, Alaska. 2. The Department alleges that the water system operates in violation of AS 46.03.020(10) (18 AAC 80.020. Source Protection), and AS 46.03.720 (18 AAC 80.100, Plan Review). 3. The water system has inadequate source protection to surrounding on—lot wastewater treatment systems. Review by the department has found a requested separation variance from 150 feet (18 AAC 80.020) to 85 feet, a danger to the health and welfare of the system users, and therefore no approval has been given. 1 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 4. The water system operates without an operation certificate. Plan review (18 AAC 80.100) by the department is required on all public water systems. The system at this time has certification by the Municipality of Anchorage as a private water system (serving a single family residence). A review of municipal records shows the system represented as serving a single—family residence. The water system is at present (and has been since original installation) a Class "C" water system. 5. The respondent has agreed to amend any concerns to the department for all statutory violations. . 6. In consideration of this agreement, the department will not pursue further proceedings nor any requirements on the water system beyond those contained in this Compliance Order by Consent (hereinafter called "Order"). The respondent agrees as follows: a. By September 30, 1988, the water system will be permanently disconnected from and no longer serve Lots 50 and 51, Block 4, and/or any other off—lot services which may have not been addressed. b. After all other secondary services have been disconnected, the water system owner shall promptly submit an application the Municipality of Anchorage Department of Health and Human Services for approval as a private water system. 1 2 3 4 S 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 7. Respondent acknowledges that should the water system not meet any provision of the Compliance Order by Consent, the Department may seek enforcement of this Order, and additionally, the Department, in its discretion, may file suit for inJunctive relief and civil penalties and/or damages under AS 46.03.020 or AS 46.03.720 or any combination thereof, and for criminal penalties under AS 46.03.790 and for any other appropriate remedy. B. The respondent acknowledges, by execution of this Order, that he is waiving rights which would attach otherwise to the procedure for issuance of a Compliance Order under 18 AAC 95, including the right to an adjudicatory hearing and judicial review of the Department's allegations in this matter. 9. The Department expressly reserves its right to initiate further administrative or legal proceedings for unforeseen damages arriving from these violations, or for any violation of this Compliance Order by Consent in the event that these terms are not complied with. 10. The respondent agrees to hold the State of Alaska and its representatives, agents, and employees harmless and to indemnify the State of Alaska against all liability, losses and damages, including any awards of costs and attorney's fees. by reason of third party claims for inJury to or death of persons and loss of or damage to property arising out of or in any manner connected with the work on the water system except 1 2 3 4 S 6 7 8 9 10 11 12 )3 14 15 16 17 18 19 20 21 22 23 24 25 26 for any third party claim arising from the negligence of the Department, its agents or employees. U. The execution and performance of this Order is: (1) not an admission by the respondent of any fact or liability relating to any matter or issue dealt with herein; (2) undertaken without waiver of or preJudice to any claims or defenses that may be asserted in the event of further litigation about or relating to the properties; and (3) not an agreement by the respondent to take action other than as described herein. Dated: Dated:Q���_ BY: _ake------- RAbet-Ko ADDRESS: _3 �_�... Zv1'Ak�Sad _Alz.A1--------- BY: Bill amoreaux�p � Regional Supervisor DEPARTMENT OF ENVIRONMENTAL CONSERVATION I F” 5. LEGAL DESCRIPT r DH. ERECEIVED INSPECTION APPOINTMENTS , TrME TIME TIME 6. TYPE OF RESIDENCE , /0 DATE DATEy DATE wo ❑ Five Thre ❑ Six r� ^ C� INSPECTOR INSPECTO �• INSPECTOR`/�J 1 V— CL..�V . since June 1975. For wells drilled prior to that date, give well IPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEGEIMifeONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 X INDIVIDUAL/ON-SITE** (JUIN 2.4 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL R E CEVED -h WATER AND SEWER FAIL DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAILING ADDRESS p0 ". �,,--„� f='L� �C,,., ,. l."o ,al�'fAi E€,,.. -E -•`/T- -. �i Lt` vt t..J PROPERTY RESIDENT (If different from above) PHONE �/TfY/%— �• . T BUYER PHONE MAILING ADDRESS - 3. LENDING INSTITUTION PHONE PHONE MAILING ADDRESS , 5_30 4. REALTOR/AGENT j _ &_/(.Q( 0-1 PHONE MAILINGADDRESS lL F” 5. LEGAL DESCRIPT STREE/1 LO��C//ATI ' A- 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS 129 SINGLE FAMILY ❑ One Four ❑ Other ❑ MULTIPLE FAMILY wo ❑ Five Thre ❑ Six 7- WATER SUPPLY * INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled T25 COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM X INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACHrR UEST B(�FORE PR/99ESSING CAN BE INITIATED. C 2-010 (Rev. 6/79))) ) Gam'" i F Fes.= YA i/ s P THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO 5d FOUR ❑ SIX ❑ OTHER- 2. WATER SUPPLY INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM NDIVIDUAUON -SITE El PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED (tom I i INSTALLER - ❑Septic Tank 6 ❑ Holding Tank Size: is ®V lJ If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA _ MATERIAL 4. DISTANCES WELL TO: tic/SepHolding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS r �J L, APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL ((etter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79) gllUNOCDPALIITY OF ANCHOr� AGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 011-135-55 Expiration Date: f 2-_ C" --1. 2 1. GENERAL INFORMATION Complete legal description Block 4, Lot 5,6,47,48; Sand Lake #2 Location (site address) 8042 Seacliff St., Anchorage, AK 99502 Current property owner(s) John & Pat Forbes Day phone Mailing address 8042 Seacliff St., Anchorage, AK 99502 Real estate agent Heather Lockhart Day phone 274-0000 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic Water Storage ❑ Holding Tank ❑ SLIBMITTA1 Community Well [1:1Community ❑ Public Water System ❑ Public Sewer ❑ AUG 2 4 2018 A{ 1W EAR ' Waiver request for: Distance: Received by: Kell Lesem. i P.E., PMP Date: 3/J S/20/a COSA to be release• o f : gin r,unl: otherwise quested by the engineer. tei 9/7/26/ 6 COSA Fee $ A Waiver Fee $ Date of Payment g-72-LI 2 Date of Payment Receipt Number 22 '1O701 Receipt Number COSA# C � l Silt Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Kelly Leseman Phone 748-6282 Address 12991 Nora Drive, Anchorage, AK 99515 Engineer's Printed Name Kelly Leseman Date 2.120/ 4 OF •• � gr. 61.,,• 4 9�b► 11% # 6. DSD SIGNATURE 14; System#1 Approved for 3 bedrooms . .Ej�Y � :4_4. System #2 Approved for bedrooms �i e„, ••• ,.• �, Disapproved " tt ,49s��0 , e Conditional approval for bedrooms, with the following stipulations: L ON-SITE WATER AND r, j WASTEWATER �: I'f OGRAM By: - Original Certificate Date: �'-(� t The Municipality of Anchorage Development Services Division (DSD)issues Certificates of On-Site Systems Approval (COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: • COSA Checklist X Nitrate Advisory Septic•System Advisory Arsenic Advisory Well Flow Advisory Other Field Report COSA Checklist blue sheet COSA Checklist Legal Description: Block 4; Lot 5,6,47,48 Parcel ID: 011-135-55 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system 1 A. WELL DATA ❑Well log is filed with Onsite(or attached) Well production at time of test 5 gpm Date drilled 61/1971 Water storage tank volume 0 gallons Total depth 321 ft Well disinfected for coliform test? ❑ Yes 0 No Cased to 40+ ft m Coliform bacteria is Negative Cl Sanitary seal is functioning correctly Nitrate mg/L CI Nitrate less than MRL (ND) 0 Wires are properly protected Arsenic 25 ug/L ❑Arsenic less than MRL(ND) Casing height(above ground) 24 in. Collected by Kelly Leseman Date of flow test for COSA 6/6/2018 Date of Sample 6/0/2016 Static water level at beginning of test 156 ft. Comments Two point of use RO units installed in house (one per floor). B. TANK DATA C. LIFT STATION Age of tank(s) 13 years ❑ Required maintenance completed Tank type/material Steel Age of lift station years ❑® Standpipes/foundation cleanout per record drawing Lift station material Date of pumping 6/5/2018 Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10't20" Adequacy test date 6/6/18 El ALL standpipes present per record drawing Results Q Pass For 3 bedrooms Total measured depth from grade 9 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 7 ft(min) Water added 750 gal 0 N/A—pressurized field New depth 2 in ❑ Monitor tubes go to bottom of drainfield. If not,state Ela sed time 150 min depth into effective p 0 Code-required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate >450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) No date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES • From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' f Yes if No ft Zi Yes if No ft Neighboring Tank> 100' al Yes if No ft Private Sewer/Septic Line>25' °s.jYes if No ft Absorption Field on Lot> 100' E1 Yes if No ft Holding Tank> 100' 'A Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' LI Yes if No ft Psi i Yes if No ft — Community Sewer Main> 75' 0 Yes if No ft Manure/Animal Excreta Storage > 100' .tYes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' i3 Yes if No ft Surface Water> 100' El Yes if No ft • Property Line> 5' Ali Yes if No ft Driveway/Parking 0' �� Y g > Yes if No, comment Absorption Field> 5' 1 Yes if No ft Wells on Adjacent Lots: Water Main > 10' >rl Yes if No ft Private Wells > 100' as Yes if No ft Water Service Line > 10' E1 Yes if No ft Community Wells >200' ❑® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation> 10' Ei Yes if No ft Driveway/Parking > 0' Y 9 Q Yes if No, comment Property Line> 10' t Yes if No ft Wells on Adjacent Lots: Water Main > 10' '. • Yes if No ft Private Wells> 100' _ g Yes if No ft Water Service Line > 10' ;Gs Yes if No ft Community Wells > 200' ❑® Yes if No ft Surface Water> 100' i1 Yes if No ft F. ENGINEER'S COMMENTS As built on record at MOA. See attached field report. . G. ENGINEER'S CERTIFICATION cal,h'� OF .4 �:� I certify that I have determined through field inspections and review Fg'A .''''I/ of Municipal records that the above systems are in conformance with g*o j49- - ` MOA COSA guidelines in effect on this date. ,' 17 at 1.a :.0. o((l�itaeeo so 0.10 no.a od0,. , ,v `� � _ o`urCf fin/'= f'Pi?0 rrc�1®0`.�.. COSA Checklist yellow sheet CERTIFICATE OF ON-SITE SYSTEM APPROVAL FIELD INSPECTION REPORT NARATIVE Sand Lake Block 4 Lot 5, 6, 47 &48. On June 07, 2018 a field inspection was conducted in concordance with the MOA COSA Guidelines dated May 2018. General Discerption: Sand Lake Block 5, 6, 47&48 contains a 1,536 sq-ft, 3 bed room single family residence built in 1956. MOA records indicate the well was built in 1971, has a total depth of 321, cased to 40-ft plus, and produces 450+gpd. A new septic system was installed and approved by MOA in 2004. Field Observations: Well: • Well casing extends 24 inches above ground level with positive drainage away from casing. • Well is capped with approved sanitary seal in good condition. • All electrical wires are encased in sealed PVC conduit and meet the requirements of NEC 300.5D.1 • Water samples were taken by and submitted to ARS Alutiq Analytical for analysis of Bacteria, Nitrates, and Arsenic. Test results report negative presence of Bacteria or Nitrates. Arsenic level reported at 25ug/I • Well pump test produced approximately 5-gpm. • Well was drilled prior to 1971. No well log exists but,well has been permitted by both MOA and DEC (file#011-135-55). Septic Tank: • The septic tank and absorption field was installed in 2004 and approved under PN SW040365/PID#011-135-55. • Tank is 1500-gal steel tank manufactured by Geer. • Tank has 4-inch diameter cleanouts for each compartment,with two opposing cleanouts downstream of tank within 10-feet of tank. • A 4-inch capped wye cleanout is located inside building on foundation wall and is easily accessible from the first floor basement which daylights at ground level on the east side of the house. • The septic tank was pumped on June 06, 2018. • The ground level over the tank is not depressed are accessible to any load bearing conditions. Drainfield: • The home was occupied for more than 30 days prior to adsorption adequacy test. • All cleanouts and monitoring tubes were identified per the permitted drawings, extended above grade, and in working order. • No portion of the drainfield is subject to driveways, parking, structures are any other load bearing activities (other than snow load). • There is no depression over drainfield. Absorption Field Test: • House has been occupied greater than 30 days. • Approximately 750 gallons was introduced into system • Monitoring wells showed no measurable fluid prior to test. After 750 gallons was introduced, approximately 2-inches was measured in the upstream monitoring tube, and zero at the end of field monitoring tube.There was no measurable fluid after 60 minutes. I certify that the On-site System located Sand Lake Block 4 Lot 5, 6,47 & 48. Has been inspected and tested in accordance with MOA Guidelines "Certificate of On-Site System Approval" dated revised May 2018 and are adequate for this dwelling. I� Kel y Leseman P.E., PMP CE#9591, State of Alaska MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • • �id 1 907-343-7904 On-Site Water and Wastewater Section �` j Fax: 343-7997 www.muni.org/onsite Arsenic Advisory Certificate of On-Site Systems Approval # OSC181434 Subdivision: Sand Lake #2, Block 4, Lot 5,6,47,48 A water sample revealed an arsenic concentration of 25 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P. 0. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org