HomeMy WebLinkAboutLAKE O THE HILLS EAST BLK 1 LT 5Lok¢ O' The Hills East Block I Lot 5 #015-333-05 MUNICIPALITY OF ANCHORAGE DE,,_ TMENT OF HEALTH AND HUMAN SERcS Environmental Health Division J S 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Na e P71w.� DISTANCES �� S ��, TO SEPTIC ABSORPTION Address a FROM TANK FIELD WELL /7-! � eu� Wb, S 17 C 7-16 Phonels) Permit No. No. of Bed oms WELL V� 4 �-a� 1, V ery S7o,? -7 / i LEGAL DESCRIPTION LOT LINE Lot Block Subdivision- 0 °T��- �• FOUNDATION Township, Range, Section rJ', r--+C,rsrgr..2-3; AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, /� — driveway, water bodies, etc) - TANKS SEPTIC ❑ HOLDING Manufacturer Capacity in gallons K��0 Material ..�r�sJ� No. of Compartments 57 %v jv 4' TYPE OF SYSTEM ❑ TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER v ,3 Depth to pipe bottom from Total depth from original grade O original grade FT FT Fill added above original grade Gravel depth beneath pipe FT FT Gravel length Gravel width FT FT � Total absorption area - Distance between lines SQ FT FT Number of lines Soil rating Pipe material SQ FT e,-77, Installer Date Installed a 4s1J el -,ii 10 13 WELLS o d 11 PRIVATE El OTHER (Identity) Classification (A,B,C) Total Depth Cased to 7F I c6719�i. A FT FT Installer Date Installed: REMARKS: Y a. Si:ale: ���' ENGINEER'S SEAL ""'�` d y' T •"'rn� ��� Inspections Performed b Date: onj 4*0 RP/eta li . I exa*ks I — --A �% > cattily that this inspection was performed according to all Municipal and State guidelines in effect t/on^this dale: Health Department Approval: v Date: —L fl / 72-013 (3/85) m MUNICIPALITY OF ANCHORAGE Desartment o� Health & Human Services S25 L Street, AnchoraOe, Alaska 99501 343-4720 UN~SITE SEPTIC lANK PERMIT Permit Number: S70271 Upgrade Date lssued: 10/O9/87 Owner Name: NORTH AMERICAN SAVINGS & LOAN Day Phone: Owner Address: 3120 S" HARBOR BLVD. 7l4~549~7300 SANTA ANA,CA 92704 Parcel Id: 15~333-O5 Lot Legal: �ubd visior�� LAKE8�THE� E, Lot: HILLS 5 8lock: 1 � Section: 23 Township: 12N Range: 3W / Lot Size 25034 (s�.�t, or acres> Max Bedroom�: This Permit: 4 Total Capacity: 4 SEPlIll- TANK: Minimum Lotal se�tic tank capacity: 1,250 gallons. Each se�tic tank must have at least 2 compartments, Depth to top o� septic tank<s> < 4.0 !eet requires insulation over tank(s). I CERTIFY THAT: 1. I am [amiliar with the requirements {or on�site sewers and wells as set �orth by the Municipality o� Anchora�e (MOA) and the StaLe o� Alaska. 2. I will instal] the s�stem in accordance with all MOA codes and regulations; and in compliance with the design criteria o� this permit. 3. I will adhere to aIl MOA and State o/ Alaska req:irements for the set �ack distanc�s trom an� existing well, wastewater disposal system or Public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid �or a maximum o{ 4 bedr�oms. I also understand that the capacity o� the total system is 4 bedrooms and any enlargeme:t will require an additional permit. Signed: DATE: .... ..... ____,__ (Owner) NORTH AMERICAN SAVINGS & LOAN Municipairty of Anchorage October 9, 1987 P.O. Bel 196650 ANCHORAGE, ALASKA 99519-6650 (907)264-4111 TONY KNO WLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Alan Wien Alaska Environmental Control Services 1200 W. 33rd Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 5 Block 1 Lake 0' the Hills Subdivision Waiver Request WR87-059 Dear Mr. Wien: Your request for a waiver of the 100 foot separation required between the septic system on the subject lot and the lake to the south has been granted. The separation distance between the lake and the existing absorption field has been waived to 89 feet. The separation between the lake and a proposed replacement septic tank has been waived to a minimum distance of 80 feet. These waivers are based on your assessment that site conditions on the subject lot will mitigate the potential of lake contamination in this case. Your soils investigation indicates that a thick layer of peat lies between the lake and the septic system which should provide excellent filtration of the effluent. The house foundation and the topography in the vicinity of the septic system should direct effluent away from the lake in the event of septic system failure or overflow. Given the fact that the existing absorption system is less than ten percent short of the required design absorption area for a four bedroom dwelling, and the fact that a recent adequacy test has demonstrated that the system is easily capable of handling the design flow from a four bedroom house at the present time, an enlargement of the absorption system will not be required for approval of the septic system for four bedrooms. The volume of the septic tank will have to be upgraded to 1250 gallons, however. This waiver is valid for the existing four bedroom, single family dwelling. This waiver does not apply to future upgrades of the system. Sincerely, Stephen S. Morris Civil Engineer On-site Services cc Gus Andress, P.E. Manager, On-site and Water Quality Programs AE CALASKA ��UIROWnTAL COnTROL S6401US, InC. kS Q Engineering & Enuironmental Studies October 6, 1987 Municipality of Anchorage Department of Health & Human Services 825 L Street Anchorage, Alaska 99501 Re: Lot 5, Block 1, Lake 0' the Hills East Subdivision The subject lot contains a 4 bedroom house served with community water and an on-site sewer system. The sewer system, installed 10/22/84, was originally for 3 bedrooms. On 9/2/87, an adequacy test and Health Authority inspection was performed. We found the separation distance to be 79 feet from the lake to the tank and 89 feet from the lake to absorption area. On 9/30/87, a soil investigation was done to upgrade the system to move it entirely outside the 100 foot setback from the lake. 3 testholes were dug all showing inadequate soil for an on-site system. All holes showed 8 to 10 feet of peat with impermeable silt below. This area, which is the only upgrade area available, is downslope from a ridge that the existing trench was installed in. The existing tank is 1000 gallon capacity. We propose to abandon this tank and install a new 1250 gallon tank at 100 foot from the lake, as shown in the diagram. As for the trench, 20 feet of it is within the 100 foot setback from the lake with the closest point being 89 feet. The asbuilt shows it to be 5 feet wide with 7 feet of sewer rock with no credit given for the extra width. Since the extra width and area exists, we request that you now approve credit for the width which would make the total effective absorption area equal to 771 square feet. See attached calculations. For a 4 bedroom system, 824 square feet of area is required making this trench only 53 square feet shy on area. Referring to the attached adequacy test data, the trench had only a few inches of water in the bottom at the start of the test. 475 gallons was added with a total rise of 1.27 feet. Drawdown data shows that this bottom area of the trench is capable of absorbing in excess of 1000 gallons per day. Surface elevations were shot on the lake level and around the sewer system. The area over the existing tank and the portion of the trench encroaching on the lake slopes to the north towards the road. The bottom of the trench is at the same level as the water in the lake. Due to the conditions listed above „we request that you grant a waiver of 89 feet for the absorption area to the lake. The excessive amount of peat surrounding the area will also provide excellent filtering of the effluent. Based on the adequacy test results, we also request that you approve the existing trench for 4 bedroom capacity. The only option available to increase the effective absorption area would be to raise the trench with an additional 6 inches of sewer rock below the pipe. This would give an additional 54 square feet of area, however, it may require a lift station if adequate fall can not be maintained from the foundation cleanout. To avoid the lift station and still raise the trench, the new tank could be installed approximately 10 feet to the north of the existing tank if a waiver of approximately 85 feet could be 1200 West 33rd Auenue. Suite 8 . Anchorage. Alaska 99503. 907) 561-5040 granted. The new tank would be water tight with the inlet, outlet and manholes adequately sealed. If you have any questions, please call. Sincerely, k---_ Alan C. Wien Engineering Technician 49 *®a • IEROY . D, JR. ; AV Q ' •Ar •000 CE .225 r *0000000* A � Pro, � LoT s 8a — y89's-7•�,,,E AO `4O dFr,J (�iCA-Tiv�.� tea+�! Exrsr.J�, j- Tt8.Je,l • 9004 - " — �• _...:.._' � obi �-,J�t� • �,`J �,z ea max, sT Jy -rAlt- Y 136 f48i+ M1R-b L 23a eC-ev- -fiba• � r �d� a ego J+o E d 0 �5w / nl9 0 20 ei O �� N 203 rV A�C B.dd eoeoo oa o0 e p w �c, ° 49T I °°��g S76,00 a2 o�ri17. �•� j e000 e,a S '� sr ve.eeaee E t 4 e 000S2�.e•.�, o et^'s/s. oae� we ®e URO Y REID, JR.: Robert P. Drayer e 4 y ���sr ° • - 2251e o� �r �� y� LS 7063.E � ��$®� Of SS10.646f) OW 8�L1!Sklr zffm It is me WNW - - - - - - res9eeetelt7tY !n Aebermtra tM /IBJ ://J 2 O. �. 3 �D� a ,•1«t. � r• TWO I. I �) S r100,11 1Al f Irl f 31 '.GV. i Ir l n 5 1,-,/ ( F51 FL I / �/ / 0 'r .JA -rete revrG rAI GAXE; �'� . � f � f , •"! ar-�r /d✓mar OF Baa ae4i.e cur ierr, ly f � I / SYMBOLS / SURVEY TYPEDRAINAGE f O ELEVATION �. Q AS- BUILT - NO CORNERS SET �_ WOOD FENCE ❑ PLOT PLAN - AS -BUILT - LOT SURVEY -TOPOGRAPHY -�T CHAIN LINK FENCE ❑ LOT SURVEY NOTE: Fences are shown in their approximate ❑ RECERTIFICATION AS -BUILT - NO CORNERS SET locations only. ;t is the responsibility of the builder or owner, prior to LEGEND hub 8 tack -found E3 set iron riper cc.ns'ruction, to verify proposed building grode relative pipe -found O set O to finished grade and utility connections andto determine brass Cap -found -set 'oe ex�s-ence of any easements, covenants or .restrictions wh:rr do net appear on the recorded subdivision plat. alum. cap -found a set e i_c;t Survey CE-ti`icaFion Pre or d by BENCH or INC. 1 here7y cer2ily'hW I hive ..�••,,,,,,=.'1.;', Professional Land Serve ors •u•veYed the ty shown _.-.d _ "`.- Drawn by- deocrt-ad hereon, and .- .. it ' Scale= 1" = 40' WAS 1':c impro.e^ier`s s't,;o*ed -t`, seen wiin:n t`.e pr-:rertY of and dnat overl .. u . Date Surveyed- 2/25/1985 Chocked e d byREJ on od)acon' or^i !'•W.O. a -d ta31 na in: rw - C�5 an '• � ... p c G. LSt,tae, p Dote Drawn- 2/26/1985 Grid 2639 M -02E.'7: of C`ICii"y, •t':r. J/ e :r c:h cn tt!a ; r:;ts in Legal Description. r a1sit;I (.I;., •?�i-.t-on - LOT 5, BLOCK 1, LAKE 0' THE HILLS EAST SUBDIVIS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: SF3 ,���L' - DATE PERFORMED: LEGAL DESCRIPTION:L-!rS/ L,*-vE U, 7 ,4<<r �r Township, Range, Section: -7-Ij Al jZ3A SES Zj DEPTH - SLOPE SITE PLAN (FEET) 1 '�-7� 2 3 X007 u�l= 4 5 6 7 8 9 R� 10 11 Edi 'i# 12- 21314 13- 14- 15- 15 16 16- 17 17 JR. 18 o 'R.IUY C. RFID, °o 295 c� 19 WAS GROUND WATER /O ENCOUNTERED? �( IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: 20-j ...... j PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS i PERFORMED BY: �CS A, 1 AZ -L1 J A24--- CEF ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 79-nnR [Rau d/k51 . IFY THAT THIS TEST WAS PERFORMED IN 9 -3.4 �� (ENGINEER'S SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: SGbreJ/C, DATE PERFORMED: 7 LEGAL DESCRIPTION: LSB/ 1/1rZ,,6;' // )�tL3 township, Range, Section:/I y,f–P,3 tom) Sg"% Z-3 DEPTH SLOPE SITE PLAN (FEET) 2 3 4- 6- 7 67 8 /L/ 9 10 11 12 i i 13 14 E,�lD WAS GROUND WATER / ENCOUNTERED? PjGGC/6RFr� �+� IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: OF A 16 T H 17 ,e ° V Y•YooeY sae° 18 p Y A a 00000."" !w : Y C. REID 19 �4, CE - 2251 1 Reading Date Gross Net Depth to Net Time Time Water Drop Y9 YYC94 •OOOY R. e At 0 20- �BgSaa��'E COLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS 5014- !46110 73r GZ- PERFORMED BY: ' 2F'G5 A` ZJIE CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 2 -Jo / —ef w Ul€ r �� 0a /� �i• C4i1 a z; SEAL) 0 GO • Municipality of Anchorage 0oe eeeeo• o ;me o es DEPARTMENT OF HEALTH & HUMAN SERVICES d 825 "L" Street, Anchorage, Alaska 99502-0650 : R C. RI ID, JR. - Ce -2251 e SOILS LOG - PERCOLATION TEST ®q�;'° PERFORMED FOR: SEtpJ/C.E,' - - - DATE PERFORMED: LEGAL DESCRIPTION:jsgtd`! jLLS . Township, Range, Section: -Al Z3,�J iff-e: y3 DEPTH SLOPE SITE PLAN - - - (FEET) - - 1 2 FILL N 3 moi/ 4- 5- 6- 7 567 8 ! �. 9 10 11 12- 13- 14- 15- 16- 17- 18- 191 213141516171819 Yr WAS GROUND WATER ENCOUNTERED? d S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? Dale: 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND - FT COMMENTS 1tolL r�tSyr: '�G j�,e �St-SJ?e� 9�fJ��' PERFORMED BY:%2 I _ `CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /7 -'50 —,?-7 72-008 (Rev. 41851 - - - - - ALASKA ENVIROK ,cNTAL eoB L S /3 1-t s 67f..r7 CONTROL SERVICES, INC. SHEET NO. OF 1200 West 33rd Avenue, Suite B cJiE� ANCHORAGE, ALASKA 99503 CALCULATED BY DATE 16'4-87 (907) 561-5040 CHECKED BY DATE /2ALASKA ENVIRONM�II TAL JOe�e r CONTROL SERVICES INC. wwom«o w o zi 7o a 15, of 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 CALCULATED BY DATE 9"Z (907) 561-5040 CHECKED BY DATE SCALE '-.. 1e :a e GY t 4 Natcg Q �:eS/ue Ar fir/ %tom �s i 9s 71s -- 4i b! Ca) 4D! hl e ter Q P`1' pox b. - SY s/ p i 53� .7/Q o - �6 --° - 399 3: J 9 8' 3 8 9 : FlSr �3v 9 Z.38 d - --- . /y _ ..... ..._ �� 9 ....._ , -------_. _ - ... z7 r _............. --- C _: �, ..s .... : _ . _. �95'o 407 _ X5 9 _ 356 - 3,9 .. /ero -. G3 ; 39 3 3.9 i- /o - /i3 A.,ys ._....... oz oa x Baa biF . .. y _ /2 . _ zy _. . rfl 1 Z3 oy a x ..__ a� 6vF - rz - - Us) - 3 07 Ivo 6�F ✓yC 9 .. o1, .a a9 x aav -- __ _... o C4 Gro lP.f-..:; / _u _.7�.. -_ . .... — - _. -- r , a. 14 c,G 4 l? _ .. 3,0 Z.o /.0 ALASKA ENVIROI,,, rXNTAL JOB CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B SHEET NO. CF - ANCHORAGE, ALASKA 99503 CALCULATED BY DATE (907) 561-5040 CHECKED BY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE KNEW AI-O3 PZ I J,. I?)LzizR x`22 -/ol jr ❑ UPGRADE MAILING ADDRESS 1,1220 C2on1 C:iP-CLkF 4MC14 t2 6i' 4K ciqs4s LEGAL DESCRIPTION �Q(j 1 5- ISIC-L l 49 C- OP i I+I= j4aLI-S �12 N 23 Lv ScC LZ. LOCATION NO. OF BEDROOMS 1'iExLt=Ps 5 i 3 DISTANCE TO: Well CUMI� Absorption area Dwelling '7 / PERMIT NO. 81-16-738 U Y W Q Manufacturer C�j2 C (� 2 Material No. of om artments L P wF Liq. capacity in gallons /� Q D IF HOMEMADE: Inside length �._ Width_ Liquid depth OOz DISTANCE TO: Well Dwelling PERMIT NO. = z H Manufacturer Material Liquid capacity in gallons O W = DISTANCE TO: Well i comij Foundation f Nearest lot line 3U1 PERMIT N C./ 73 0 J - z z w No. of lines Length of each line 5 Total length of lines .� Trench width ieMes Distance between lines ~ ¢ H Top of the to finish gradeI Material beneath the Total effective absorption area nches /5(, (j2- Length Width Depth PE RMIT NO. e Lu (7 i i-- Type of crib Crib diameter Crib depth Total effective absorption area w °L w y Well Building foundation Nearest lot line DISTANCE TO: •�--- �'- Class Depth Driller a Distance to lot line PERMIT NO. liq Lu Building foundation Sewer lines_ Septic tank Absorption area(s) DISTANCE TO: L •�- OTHER T�t PIPE MATERIALS 1L TP _ 0303L/ SOIL TEST RATING ,ZI a0& aZl/�iZ 30 INSTALLER Ary, I� C` sea-X1-(05 &X OJ REMARKS IE NU CPEDAT -O(L OXT iv D T N71 jlJsuk.^* aou ()wFk/Mr- U-1LD2lUE- PnffiCdL G i- a k;=� kEzY t3o TWc-P6CTED �7 91t n ��i TC i d IfJF C i AA u C-i it APPROVED DATE LEGAL �,t,6IUf 21 '3 L( L t F(;/u (RKI= 0 F Tlk i1- �i5 TIzA) P- x TANK MUST HAVE AT LEAST TWO COMPARTMENTS 1: certify that. 1.. 1 aun i;[mlliar' with the I'equirernf?ntsi 'ior ori--si.to sit:.vipr's arlu we'i.I<_i forth by the M;.miCipal.ity of Anchor,age 0-10A) nri the St<,te of AI l'a:ika. ?. I wi.l1. 7.1i 'l. ial 1.1 'L 11 f_i iays.5'!'. E'in ii aC:coi"vl:1r`}Cf Shr i'C. hl ma .L 1. MO( C�(:f iJ?is ar"tu r{t-?s4"ilc't'L..:L C)ri';g and in C:oonpli.3nC2 With tLir, uC_sigii C:: r'` 7.' L'er'?e, Cif this I:)L::�r'tinit. 1 ('d .i.l1. c�ul-,ei,e 'L•{;,) all MOA anC:1 tStevt.f.--..' of I'�lasfka r' E n%{i..t:i.. r e lmL:n is il�r, the ._.-ft r. '.;r i:.. t.. .. ... s,... .,y ., '1 disstanCes Lr'ocn ::•iri'y' Exii-.3ting wC^ll1 .fiJsi=;tf:?!Mater dispos;.11 _aya(.t".m of (:.}�il "ic saw(eratge- GySt.21n an t.hi,.5 or any ,-=tu..je=cemt or` noc'.trhy lat. - 4. 1 t.inuerstdnu that •1.his3 p(ermi.t is vall.0 for a rnaxi'DUCA of !:.)E'C1r 00MIS c'.riu any r_an l�-:r cS r_1mc�nt will. r2r�uir(=._ln <acld itit.}nl permit. . ,T.F A !__:LFT STATION IS INSTALLED 11\1 I _.F. 'Y' C3 IL-=' 6:" h Pi, 1.1 iL : = 6 0_:3 F,";° C-§ E 'THEN (1.) AN E1..L::CTRICAL. F'ERMI'T AND DEPARTMENT OF HEALTH AND ENV I RON IENTAi_ PROTECT I ON WILL_ hd0'1 BE APPROVED WITHOUT AN ELECTRICAL 1325 I_ t:S'1•F:EEI_ n ANCHORAGE, (OFtACit=; (;I<: 4 �:,i i :l �V tY LO=i; 1.ElDONE ZAI 264_.aL72 3 ELECTR l:Clt?"d., SIC3NED F,, E:- "!Cry"11 :A _ 1 APPLICANT- f-`ERMIT NO- S4C)7; S 1SSLJED BY DATE ISSUED,, �o: -3/29/8/1 I- ea-.,,-✓ /��e;��-�e/ /i.�.'�� �..v /J � Xao--`-- AP171L.ICAN'fs A1 ... BtERT J BIERRIA JR. � V _................ __ ........ .!.., ...............J^........._... �/ ADDRES- 3'- 12EI20 CRON CIRCLE ANCHORAGES AK ?9515 CONTACT PHONE' 522-101:5 1_.EGA-L_ DESC"RI1=' SUBDIVISION- LAKE JIF THE HIL.L_3 E. [J]T. 5 BL_i_1(,V"1'':c I ;ECTIONo ^' 101WNSL-111P. 12N RANGE:" 3W. LOT SIZE-, 2 C)UC) (SQ.1"T. OR ACf:E.,OD MAX BEDROOMS' _ Lint. -d below are, the options �--vailable -11.o you in cle==_,icJning, your,;Fptic SysBtGrn. Choose the apt ion th n.t be2sst f i.LS yot_ r, s34.'1'. E?.. _.. _. .... ..... ..•. __ -- ._ ._.. _. __ ._. _._ __ ._ __ _. ..._ ._. _. _._ __ f<M: EE °;j i _. _. __ _. .._ ..... .__ .•.. ._.. _... .._ •.. :1.•_x x.....13 @,.4 .. Dt F:;� IF ..._ .._ - ..._ V,,11 DEPTH TO PIPE BOTTOM (L='•T'.) LL. 0 4. o 4. 0 GRAVEL. DEPTH (FT„ ) 7.5 0.5 35 .5 TOTAL. DEF"TH (FT.) 11.5 C,5 7. 5 GRAVEL_ WIDTH (FT. ) 2,, 5 22. ( C} GRAVEL LENGTH (1' T.) -112. (:) 42.0 67. ON GRAVEL. VOLUME (CL.J. YDS. 7 11.2 34. `3 TANK SIZE (GAL -S) 1.yc)()C).:) ' ''r 1.�t(10() (i .x 1,i+.'iC)C}.Cy .x..r. SOIL._ RATING (SG..F"T. /BR) 206 01 c06 x TANK MUST HAVE AT LEAST TWO COMPARTMENTS 1: certify that. 1.. 1 aun i;[mlliar' with the I'equirernf?ntsi 'ior ori--si.to sit:.vipr's arlu we'i.I<_i forth by the M;.miCipal.ity of Anchor,age 0-10A) nri the St<,te of AI l'a:ika. ?. I wi.l1. 7.1i 'l. ial 1.1 'L 11 f_i iays.5'!'. E'in ii aC:coi"vl:1r`}Cf Shr i'C. hl ma .L 1. MO( C�(:f iJ?is ar"tu r{t-?s4"ilc't'L..:L C)ri';g and in C:oonpli.3nC2 With tLir, uC_sigii C:: r'` 7.' L'er'?e, Cif this I:)L::�r'tinit. 1 ('d .i.l1. c�ul-,ei,e 'L•{;,) all MOA anC:1 tStevt.f.--..' of I'�lasfka r' E n%{i..t:i.. r e lmL:n is il�r, the ._.-ft r. '.;r i:.. t.. .. ... s,... .,y ., '1 disstanCes Lr'ocn ::•iri'y' Exii-.3ting wC^ll1 .fiJsi=;tf:?!Mater dispos;.11 _aya(.t".m of (:.}�il "ic saw(eratge- GySt.21n an t.hi,.5 or any ,-=tu..je=cemt or` noc'.trhy lat. - 4. 1 t.inuerstdnu that •1.his3 p(ermi.t is vall.0 for a rnaxi'DUCA of !:.)E'C1r 00MIS c'.riu any r_an l�-:r cS r_1mc�nt will. r2r�uir(=._ln <acld itit.}nl permit. . ,T.F A !__:LFT STATION IS INSTALLED 11\1 AN AREA COVERED BY MOS; DU11_.1)Ih•IG CODES� 'THEN (1.) AN E1..L::CTRICAL. F'ERMI'T AND INSPI-.E. MUST BE ('.i:"f II,El.D;; (2) AS"BL{:I:L.T WILL_ hd0'1 BE APPROVED WITHOUT AN ELECTRICAL 111SPECTION REPORT- AND (:.') THE tY LO=i; 1.ElDONE ZAI L.ICE_EwTiICA_ 1\1w3EG ELECTR l:Clt?"d., SIC3NED Gr DATE. APPLICANT- ALAI tJ T9TERRIA JLt. 1SSLJED BY i D'ATE.� s/._.__. ___.._._...._.._._.._..__...__...._ ............. _... _................ __ ........ .!.., ...............J^........._... �/ -� . .. MUNICIPALITY OF ANCHORAGE . DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG - PERCOLATION TEST 17 SOILS LOG gwe-73 y PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: '�/—,26 r Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. Oi5::.~'~:~-O.~ 1. 'GENERAL INFORMATION Complete legal description · Location (site address) Expiration Date: Current Property Owner(s) K¢i~k Mailin'g' address Day phone Lending agency Day phone Mailing address Re~l E~'tfite'Agent _D~o~to;, ~. Mailing Address Unless otherwisei r'equested~ COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: ,. TYPE OF,'.WATER SUPPLY: Individual Well Individual Water Storage Community Class. /~, Well Public Water System Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 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 sample results. (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 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 S~¢..~z,v~ Address 2,o3 CO, i5~k Av~, Engineer's Printed Name Ak, DSD SIGNATURE ~"/' Approved for Disapproved. Conditional approval for bedrooms. Phone bedrooms, with the following stipulations: By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Rev, 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST LegalDescription:..[_~,~e.. O' ~r~¢ ~{1/5 ~-~SJ[ [~1~,, ~ Lo - ,5 ParcellD: A. WELL DATA Well type .~, ~)1{(. "A" Date completed. -- Total depth -' ft. IfA, B, or C provide PWSlD #..¢,t ~00~ Well Log (Y/N) Sanitary seal (Y/N) -- Wires properly protected (Y/N) Cased to -" ft. casing height (above ground) FROM WELL LOG AT INSPECTION Date of test Static water level Well production --- WATER SAMPLE RESULTS: ft. ft. g.p.m. ~ g.p.m. Coliform ~ coloniesll00 mL Nitrate "' mg/L · Arsenic: --"- ug/L 'date of sample: ---' B, SEPTIC/HOLDING TANK DATA ..Tank Type/Material. Anc~(~¢o.e~. 'Ta~-I J Tank size t'~50 gal. Number of.Compartments Foundation cleanout (WN). 'Date of pumping (ill~I C. ABSORPTION FIELD DATA Date installed Iol:Zz~ Soilrating (g.p.d./f¢or~~ Length 5~ ft. Width ,5 Totaldepth II ft. Date of adequacy test Fluid depth in absorption field before test J;~ in. Elapsed Time: i300 min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type) Other bacteda " 'colonies/100 mL Collected by: ~ Date installed ~, Cleanouts (Y/N) '7' Depression over tank (Y/N) /V' High water alarm (Y/N) /V' · Pumper ft. Eft. absorption area ~5~ ftz Monitoring tube ~//~.oto Results(Pass/Fail) P,~5 Water added [~50 gal. __ in. Absorption rate >= System type ~8¢-~ %r~_k, Gravel below pipe '~' ~ ft. ~epression over field For ~'1 bedrooms New depth 5,.~ in. (o00 g.p.d. If yes, give date - De IglFT .STATION Date installed "Pump on" le~. Datum SEPARATION DISTANCES Size in gallons "Pump off" level Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Manhole/Access (Y/N) / High water alarm level at / in. Meets alarm & circuit requirers? On adjacent lots Absorption field on lot On adjacent lots · Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation +.~51 Water main 4- lO ~ 'Wells on adjacent lots ~00j Property line. 'f IO Water service line Absorption field Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 4- {0 J Building foundation Water Service line -I- lOI Surface water '~ Curtain drain 4. 501 , M~.~ ob~rv ~ Wells on adjacent lots COMMENTS Water main + I0I' Driveway, parking/vehicle storage. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Nam,e. L 3~¢,5 ,~p~4,,- ~,~ Date 'll~l~.O~O COSAFee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. , O I ~::~. ~) ~'~?~-~--~ COSA# · '". :-,' ,~*~.' :-_ Expiration Date: 1. G EN ERAL IN.F~)I~MA. TION Compl'ete legal 'descri~,tion I.a ~. Lo~atio~ (site address) l{O'{I Current .Property oWner(s) Mailing' ~idd~ess J ~."~ ~or~'3er~ .~ru~'c¢. Day phone Lending agency Dayphone Mailing address Real Estate Agent Mailing Address Un/ess otherwise requested, COSA wi//be hem by DSD for pickup. NUMBER OF BEDROOMS: ~ 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ,~t Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ~. Individual Holding tank [~ Community On-site Public Sewer [] The Municipality of Anchorage Development Se~ices 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. Cedificates of On-Site Systems Approval are required for the transfer of ti'Je (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 sample results. (Certificates may be reissued for a pedod 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 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 lype of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage flies 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 / Engineers Pdnted Name ~ 5. DSD SIGNATURE t//'' Approved for Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments WATERAND · m- WA51P.:vvATER: : PROGRAM ,' ,. · ' .q"' .-' ,'. ..... .' By:. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other. Original Cedificate Date: //~)//'~ ~'/~ 7 (Rev. 11~5) Municipality of Aochorage Development Services Department Building Safety Division On-Site Water & W~t~r~°mgr~m ~ 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995196650 www. mudi.o~'g/onsite (~07) 343-79o4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST A. W~LL DATA Well ty~e ~. If A, B, or C pn~le PWSID # 213~0~ Well Log (Y/N) Date completed ~ Sanitary seal (Y/N)" Wires properly protected (Y/N) Totel depth -- ff. Cased to '- ft. Casing height (above ground) '- in. FROM WELL LOG AT INSPECTION Date of test Static water level ft* WATER SAMPLE RESULTS: Golfform -" colonies/lO0 mL Arsenic: -- mg/1 g.p.m. Nitrate "- mg/L. Date of sample: --- ft. g.p.m. Other beatnri~ Collected by. .. SEPTIC/HOLDING TANK DATA ! TankType/Material ~nC~l~l. eQ,, '~/Jcf~'/ J Tank size ~ gal. Foundat~o;~ (~ea~oui (Y/N) '/ Date of pumping ~__ C. ABSORPTIOH FIELD OATA Length gq' fi. Date installed Number of Compartments 7. Cleanouts (Y/N) Del~ession over tank (Y/N) ~ High water alarm (Y/N) Pumper ~'~qc~ Pu,,~,~;~,~ Sail rating (g.p.d./fl2 Width ~ ~ ft. Gravel below pipe ~ I ft* Totaldepth' II ft. Eff. absorption area '~G Date of adequacy lest ~l//z~0'~ Results(Pass/Fail) Pe,~ For ~ bedrooms Fluid depth in absorption field before test O in. Water added ~ Z(,~ gal. New depth 1'9 n. Elapsed Time::0~ min. Final fluid depth H in. Ab$o~'ption rate >= /'t'~O g.p.d. Any rejuvenation treatment (paat 12 mo.) (Y/N & type) D. LIFT STATION Date installed - / Size in gallons -: - ---~- - -.-Manhe.io/,a~ss (Y/N) · ~ 'Pump o~ 'Pump off'~n. High wata~ Da~gm~ '7 Cyctes.~ed Mee~,,,~ & circuit requiremems? E. SEPARATION DISTANCES in. SEPARATION DISTANCES FROM WELL ON LOT TO: Co,~,~'~' ~/'~ C/~_~ ~[ * Septic tank~lff station on lot Absorption field on lot Public sewer main Sewer/septic service line '-' Animal containment areas On adjacent lots -- On adjacent lots -- Public sewer manhole/cieenout - Holding tank -- Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation + Water main 4. Water sen4ce line -t- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Pr. o.,pe~? line 'Y lO ' Building foundation ~r ~0 'f Water Service line .~ JO Surface water ~ ~1 Curtain drain ~ Wells on adjacent lots · ~1)O' F. COMMENTS Abserptlon field Surface water Water main G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conf~mance with MOA COSA guidelines in effect on this date. COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) I O /tO /O Waiver Fee $ Data of Payment Receipt Number '--'-- MOUNTAIN LAKE DR ~-._ / I / · o. ! \ }.:'.'// ~, ...i.. i ,// / · ~."" '"""'"~' ~e.o'- ,,' ~ / / /-.,~ , --~~ - /,,' _,v"5,~~ . / / / ~-/\ - ~ /,. / / / \ /#/ / '~,,, - 4.'?/ / / · ~..,, \ ,',' / .. ~Y '~"~" -~...~.~..~,_~, Robert E. Johns, ;Jr. ASSOC.· ,.~t,u~ Profeaatom~! L~nd Surveys1 · ------..---- . . ~..1.7_0'7 RS3' · I~OT Pt.~NS · LOT sum~ra Environmental Consulting and Design Municipality of Anchorage Development Services Department Building Safety Division On Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Alaska 995 i 9 Subject: COSA REQUEST Lake O' the Hills East Block 1 Lot 5 October 9, 2007 Dear Jeff Poet, During the COSA review process it was discovered that a potion of the drain field serving the above referenced lot lies beneath the drive way. The top of the sewer rock is 6 feet below the driveway surface. The monitor tube is protected by steel caps, marked sewer, flush with grade. The section of trench underneath the driveway does not appear to be in the typical travel lane (i.e. vehicles would not typically travel over the trench to access the garage). There is no depression over the trench. The trench has been in service since 1984 and the recent adequacy test did not indicate any adverse effects do to the driveway. If you have any questions, please contact me a 279-3916. Sincerely, 203 West 15tb Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng~gci.net · unicipahty ANCHORAGE. ALASKA 99519-6650 Anchorage MAYOR October 9, 1987 D£PARTId~NT OF H~Ii.YH · HUMAN SERVIC£S Alan ~ten Alaska ~ironmental Control Services 1200 V. 33rd Avenue, Suite B Anchorage. Alaska 99503 Subject: Loc S Block 1 Lake O' the ~llls Subdivision Waiver Request l~It87-0~9 Dear ~r. Vien: Your request for a waiver of the 100 foot separation required between the septic system on the subject lot and the lake to the south has been granted. The separation distance be~een~he lake and the existing &bsor?~lon field has been waived to 89 feet. The separation baleen the lake and a proposed replacement septic tank has been waived to & minimvz distance o~ 80 feet. These valve,s are based on ~our assessment ~hat site condl~io~ on loc will ~[~lga~e the ~o~en~ial of la~e con~l~ion in ~his case. Your soils /~estigation indicates tha~ a thick la,er of pea~ lies }e~een ~e la~e and ~e septic system which should provide excellen~ filtration o~ the ef~uen~. ~e house fo~/on and ~he ~opozraphy In septic system should d~ec~ ef~uen2 a~ay fro~he lake in,he tven~ of septic sys~e~ failure o~ over~ov. Civen ~e face tha~ ~he txis~ln$ abso~lon sys~e~ is less ~n ~en percent ~ho~ o~ ~he ~equl~ed desl~ abso~lon a~ea for a four bedroom d~ellin~, and ~a fac~ tha~ a ~ecen~ adeq~cy ~es~ ~s demo~ra~ed easily capable of handlin~ ~h~ dest~flov fro~ a four bedroom presen~ ~lme, au enlargement off the abso~lon system will no~ be ~equired for approval of ~he septic ays~e~ for four bedrooms. ~e vol~e o~ ~e septic ~a~vi[1 have to be ~graded to 1250 gallo~, however. ~is waiver is ~alid for ihs exis~ins four bedroom, single f~ily d~ellinz. ~[s waiver does ~oC apply =o future upzrades off the system. Sincerely, Scepl~en S. riot-tls Civil Engineer On-site Services cc Cus Andress, · Hanager, On-site and ~a~er (luality~zogra~s MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES y e Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# - 2)7�-('�, �) 1. GENERAL INFORMATION HAA# Complete legal description Lot 5• Block 1 • Lake Q'The Hills Fast - Location (site address or directions) 11071 Mt. Lake Drive Property owner Brent Jennison L � �C) Day phone 346-2500 Mailing address P.O. Box 92772, Anchorage, Alaska 99509 Lending agency — City Mortgage Day phone 277-0700 Mailing address 121 W. Fireweed Boulevard, #120, Anchorage Alaska 99503 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: A- �' 3. TYPE OF WATER SUPPLY: Individual well Community well X Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 lZa vOw HOEG MA'A08) S&C ZU ->IaoM s�aauibua leuolssapoid aul ul suolsslwo ao saaja aol ajglsuodsaa IOU sl a6ejog0uy to LllledlolunW aUl *panssi si aleolllljao e ajopaq elep az (leue jo suolloodsul lonpuoo IOU op SHHa to saaAoldw3 'sluaweimbei @leis pue leaapap uleliao Alslles olaapio ul suollnl!lsul 6ulpuel alagl pue sawou po siaseuoand of (selinoo a se s!Ul scop SHHO a14 ' sely to apelS aql ul paaalslbej aaaulbuo leuolssaloid luepuadopul ue (q anoge g gdea6eaed ui uanl6 suolpeluasaidaa aql uodn (luo paseq saleolplpaao lenoaddy Allaoglnd glleaH sonss! (SHHa) saolnaaS uewnH pue 41120H po luawlieda4 ebeaogouy to AllledlolunN aql m :suollelndlls bu!anollop aql ql!M 'swooapaq ® �.h),5S3joy ��' �0y99066 0P u 0 Q,c �' •p ?fit: �po C:Zic Cil a d3avH r CP •� li r V UY+ SISPIIf I `' Q( �ibb6 N" c4�i —Z L, 1 algia m sluewwo0 Ieuolllppy aop Ienoadde leuoll!puoO •pano,iddesla •swooapaq T aol panoaddy –x— �/ 3unIVNJIS SHHa '9 ainpeubis s,aaau16u3 L566 e1lse!y aoAIS UI U: ssaappy PWON paob dool 40nla GIOU l b£OLL auogd ONMENION3 S'S S i.uald po aweN •uolpoadsul slgp po alep aql uo poelpa ul suolleln6aa pue 'seoueulpao 'sapoo apelg pue ledlolunW Ile L4 ;!m aouelldwoo ul sl welsAs lesods!p aapamelsem ao/pue Alddns aalem apls-uo aqp 'uolloedsul pue u01pe6lpsanul Aw woap pue sallp ebeaogouy po Al!ledlolunW agp woap pauiepgo uollewaopul aqp uo paseq legpAplaanaagpanp I •ulaaaq paleolpui ainlonapspo ad/p pue swooapaq po aagwnu aqp aop alenbape pue Ieuolpounp 'apes sl walsAs iesodslp aalemalsum ao/pue llddns aalem alis-uo aqp pegp smogs uolleo!Idde lenoaddy Al!aoglny glleaH s!ql po uolpe61ps9nu1 Aw pegp Aplaan I 'nnolaq unnogs @pep uo!pep!Ien agp po se pue opaaag paxlppe leas Aw Aq palplpaao sy I133NION3 AS NO11O3dSNl dO LN3W31` IS 'S Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L crr S ?2t~� I L A V� r)' Parcel I.D. 1kXws E-ks-r'S> A. WELL DATA Well type A If A, B, or C, attach ADEC letter Log present (Y/N) Date completed Total depth Cased to Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump leve SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 2bv ik Absorption field on lot Public sewer main Sewer service line. WATER SAMPLE RESUL' Coliform of sample: B. SEPTIC/HOLDING TANK DATA Nitrate ADEC water system number Z t '5t 03 Driller Casing height Wires properly protected AT INSPECTION g.p.m. ; On adjacent lots On adjacent lots — Publizetrol=eumtan7kdl�� Collected by: Other bacteria Date installed 10 -13 ' Sy Tank size Compartments 2 Cleanouts (('ay'N) Foundation cleanoutaN) Depression (Y& tJ High water alarm (YIQ /" Alarm tested (Y/N) 4 Date of pumping i3 —`�Z Pumper-� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 2vo On adjacent lots �IA Foundation 1z�t To property line 10 -Absorption field t Water main/service line ID { Surface water/drainage au25 U�enJ6� ���+� �'�'S'► 72-026 (Rev. 7/91) Front _ - CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes — Manufacturer Manhole/Access (Y/N) . Pump off' level at Cycles tested SEPARATION-OTSTANCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA On adjacent lots Surface water Date installed k - 22 ,34 Soil rating 1_,CL System type _D (Z-A�t�i✓t��-L� Length S9 Width 5 Gravel thickness 7 Total depth Total absorption area 7 7/ Cleanouts present/N) Depression over field (Ya /J Date of adequacy test /D - 27- 9 z- ResultsJEEgo/fail) PAss for r—OU - L-1 ) bedrooms Peroxide treatment (past 12 months) (Y&) AeJoad If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot �::. `Je On adjacent lots "11A Property line To building foundation 1 3 To existing or abandoned system on lot On adjacent lots Zo ) �_ Cutbank '`/6, Watermain/service line /o ) 4- Surface water 9 % ufAto� y7 e.v.1 Driveway, parking/vehicle storage area— Curtain rea Curtain drain ''flit - E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect e�g date of this inspection. �3F:n oCOr. as A Et`JGINEtiRINCa 17034 r-agle River Loop Road No. 204 Signature;774 6 agie River, Alag :a 99 11! I 040GLO0 Engineer's Name �� ®Gt 0e4 ��3 p—��! 4� it illi, J. ->i`iA ia Gee -syr Date 1( s<� �e Gi Cli. i;21 i o' HAA Fee $/ Z A0 Waiver Fee: $ Date of Payment Date of Payment Receipt Number ���/�� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 sy e OF e aSNo DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 October 28, 1992 Mr. Ray Shafer S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 SUBJECT: Lake O' The Hills East Subdivision Class "A" Public Water System, PWSID 213603 Dear Mr. Shafer: WALTER J. HICKEL, GOVERNOR (907) 349-7755 I have completed a review of this office's files concerning the monitoring status of the - above -referenced Class "A" Public Water System and found the following: 1. The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on September 21, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on June 12, 1991. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 3. The last Radioactive Contaminants Sample results were submitted to the Department on July 23, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. 4. The last Organic Chemical Contaminants/Volatile Organic Chemicals were submitted to this Department on July 7, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, r ichae Environmental Eng. Asst. If panted on recycled paper b r 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALg�— OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 4~ D ryle /%ILLS ��� -7'1-7--.Al 03PJ S6C- Tij Location (address or directions) i,, AtWMJ Jrh" s � &,4f (b) � Applicant Name § Telephone: Home Business Applicant Address. 3/za (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent XAek u''W172r CO' Address ju) L 17: Telephone S(o3-SSa (f) 1, 2. TYPE OF RESIDENCE Single-FamilyyX Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well ❑ Communityv Public ❑ 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 OnsiteX 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 (11/84) ~ to ~ e6ed o/ ema ~O~-- { ~ mJ~ Jo emeN 'uo~13edsu~ slql jo e~ep eqi uo ~a~a u~ suo~1elnSeJ pue ;seoueu~pJo 'sepoo el~S pu~ I~d!o!un~ I1~ ql~ eoue!ldmoo u! s! ma~s~s lesods~p JO~Ue Xlddns Jel~ el~s-uo eql 'uo~13edsu! pue uolleSjisa~ui Xm moji pu~ sezu eSeJoqouv Io ~!led!o~un~ eql moji pau~elqo uo!~e~JOiUi eq~ uo peseq leql Xjpe~ Jequni I 'u!eJeq peleo!pu~ eJn~nJ~s jo edXl pue smooJpaq Io Jeqmnu eql e~en~pe pu~ leUO!~Ounj 'ejes si mais~s i~sodslp Je~e~a~se~ Jo/pue Xlddns Jale~ eus-uo eq~ leq~ s~oqs le~oJddv qileaH sIql Jo uolle6!ieeauI ~m )~ql XI)JeA I '~Oleq UMOqS elep uo!lep!l~A eql Io se pue OleJeq paxule lees Xm Xq paU~Ueo SV' NO~V~O~NI aNY ~VO 'H3~S ~ll~ 'S~S~ 'SNO~O3dSNI ~NIOIAOBd ~1~ ONI~)NION) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANCHORAGE CHECKLIST - FEBRUARY 1984 ENVIRONMENTAL SERVICES DIVISION 264-4744 Legal Description: 44-r� �'�K �� 7 OCT 2 01987 11r1_' -s 4�77 - rIXAI 031J A. WELL DATA RECEIVED Well Classification eef-#f If A, B, C, D.E.C. Approved©/ J) � � � Z'1300.3 Well L resent (Y/N) Total Depth Static Water Level Casing Height Above Grou Cased to Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Date Completed To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) — Depression Around Wellhead (Y/N) ; On Adjoining Lots djoining Lots To Nearest Pub i ewer To Nearest Sewer Services e on Lot ; Date Date Installed O 43'rl Size /Z$�O No. of Compartmentsy Standpipes) Air -tight CapsY/ ) Foundation Cleanout)9l) Depression over Tank (Y% Date Last Pumped A Pumping/Maintenance Contract on File (Y/N) ; for /JJ 4 Holding Tank High -Water Alarm (Y/N) /z" Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply We Il eey4 f . To Building Foundation To Property Line '©•� To Disposal Field 7 To Water Main/Service Line -' !o To Stream, Pond, Lake, or Major Drainage Course ' d SES G✓/H�iL . Comments Page 1 of 2 72-026 (Rev. 8/86) Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area . ~ ~' Depression over Field *(Y~) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Type of System Design Length of Field Depth of Field ,// Gravel Bed Thickness Standpipes Present'N) Date of Last Adequacy Test To Property Line Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~$a"¢' ~ ~/,¢-aVAf... o To Existing or Abandoned System on ; On Adjoining Lots ~'~' To Cutbank (if present) D. LIFT STATION Size in Gallons __ "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump cfr' Level at -- Vent (Y/N) g Adequacy Test. Meets MOA '° Check P~rmitted Bedroom Rating Against HAA Request ** I certify that I h a~e,,~hec,~r d. ver~'ied, or conformed to all M CA and HAA guidelines in effect on th( Signed ~-----/-~'~/d~,~'-"' Date Company /~"~ '~ ' ' MOA No. Receipt No. r/"~ ~ ~ Date of Payment /"~'~.~ C~ ~. " Amount: $ ,./~)~/~ ~"'"'~'~--~ Page 2 of 2 his inspection. pp AA OF STEVE COWPER, GOVERNOR b U U DEPT. OF ENVIRONMENTAL CONSERVATION/ ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3601 "C" STREET, SUITE 1334 ANCHORAGE. ALASKA 99503 DATE: �v �-7 ------/-_-^---------- PWSID #: _ ------ To Whom It May Concern: According to the records on file in this office. the - --= ✓yr3�o7a_ Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely__ Ronald S. Klein Environmental Field Officer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date (113h 7 1, GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, s township, range) t _.[-e• /2 1', L f i nLle X 44.1 r'rr 1(3 �-- T T/'R�1 to- aw Location (address or directions) po (b) Applicant Name Telephone: Home Business -22 moors _ Applicant Address t 2 gt2 D C-2 e,y� (1-0 ?(� (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder Z; Buyer ❑ ; Other ® (explain); �i (d) LendingVnstitution o7 �� T eph ne Address (e) Real Estate Company and Agent (f) Address Telephone Mail the HAA to the following address: ®til 2. TYPE OF RESIDENCE ,. Single -Family [b Multi Family ® ' Other g Number of gedrodnis' n 3. WATER SUPPLY Individual Well ❑ Communitylp Public El 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 P; 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. 72-025 (11/84) Page 1 of 2 A 0 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 verifythat my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date r an (D S d ss a4-e-Y6_� sir-s-0�krj "A cK ra �/ l _-i p 9 ® Ag`���_ 6. DHEP APPROVAL„ -- Approved for j. bedrooms by t � Date e� 0 Approved ,Z Disapproved Conditional Terms of Conditional Approval V���� CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. • Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264 4720 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION ItPR 51985 Legal Description: / 12A " 3L A. WELL DATA Well Classification (10z If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) � Date Completed � Yield Total Depth ��� Cased to N I A� Depth of Grouting N4 Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) w/4 rat De ression Around Wellhead Y/N w Electrical Wiring in Conduit (Y/N) P ( ) Separation Distances from Well: To Septic/Holding Tank on Lot c2r7,o ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot �20()� ; On Adjoining Lots To Nearest Public Sewer Line "(It— To Nearest Public Sewer Cleanout/Manhole (A- To Nearest Sewer Service Line on Lot 0)/ i" K//7( Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA A) ; Date Date Installed /0&(4 Size IOUO No. of Compartments Standpipes ON) Air -tight Caps 6Y Foundation Cleanout ON) Depression over Tank (Y& Date Last Pumped L/.,A- Pumping/Maintenance Contract on File (Y/N) nJ(,4� ; for °�( Holding Tank High -Water Alarm (Y/N) N i A—Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well c20OJ To Property Line To Water Main/Service Line i To Building Foundation 7� To Disposal Field To Stream, Pond, Lake, or Major Drainage Course - MUNICIPALITY OF ANCHORAGE CommentsBERT OF HEALTH & ENVIRONMENTAL PROTECTION Page 1 of 2 72-026(11/84) NOV 2 6X985 C. ABSORPTION FIELD DATA FA -6_V_ G+6I t t/1 \ - �s•r Soils Rating in Absorption Strata Type of System Design Tei:� Date Installed lo��� Length of Field Width of Field Depth of Field %� y Gravel Bed Thickness 7 Square Feet of Absorption Area `%� Af Standpipes Present (Y/N) 0 Depression over Field (Y Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 1) To Building Foundation Lot N To Water Main/Service Line Date of Last Adequacy Test NIA <I4. To Property Line 3U / To Existing or Abandoned System on On Adjoining Lots i t To Cutbank (if present) A - To Stream/Pond/Lake/or Major Drainage Course �o o r �F To Driveway, Parking Area, or Vehicle Storage Area • Ld,1 � zzs acti "P, i r C D. LIFT STATION Date Installed 't-tk Dimensions /L)/A- Size in Gallons 1 k Manhole/Access (Y/N) { �J-- "Pump On" Level at lu14 "Pump Off' Level at K)I/fl High Water Alarm Level at I� Vent (Y/N) Aj/q Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments " Check Permitted Bedroom Rating Against HAA Request "` I certify that I have che,cke , verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date 3/ 5 Company r! C (/ MOA No. k5 -D2<i 'Z O % �•e soo e e oe �•�_Ry ji Receipt No. '��� �l4''7 G�06';9 °�°➢p� `� Date of Payment •.e e. ee ®°�enee 6.3 Amount: $ oY C. Reid, J9, j No. aa.5t•I: v t• Page 2 of 2 d <'t 72-026 (ivea) EF 0"F VA S 98 81IL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ;T Telephone: (907) Address: t' ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE T PWS I.D.# C Z &66 To Whom it May Concern: According to records on file in this office the Water System is in compliance with the State Drinking Water Regulations Sincerely, J, 4t dmlll�