HomeMy WebLinkAboutLAKEWOOD HILLS #2 LT 22 Lakewood Hills
# 2
Lot 22
#015 - 134 - 18
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP161222 PID Number: 015-134-18
Dwelling: ❑■ Single Family(SF) ❑ Duplex(D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade
Name:
Larry & Helga Berry ABSORPTION FIELD
Address ❑ Deep Trench ■❑ Shallow Trench ❑ Bed ❑ Mound
P.O. Box 112230 Anchorage, AK 99511 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
346-23921 5 1.2 GPD/SF 8.5 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 4.5 Ft. 4 Ft.
Lakewood Hills #2 22 Fill added above original grade Gravel length
Township Range Section 1 Ft. 2 @ 39 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 5 Ft. Ft.
To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line 780 Ft2 t. I)Q.,- ME r, 0 Ft.
Well >100' >100' NA NA >25' TANK ll] Septic ❑S.T.E.P. ❑ Holding ❑Other
Manufacturer Capacity
Surface Water >100' >100' NA NA Anchorage Tank 1,500 Gal.
Material Number of compartments
Lot Line >5' >10' NA NA NA Steel Two
Foundation >5' >10' NA NA LIFT STATION
Manufacturer Capacity
Curtain Drain None Noted Gal.
Pump on level at Pump off level at High water alarm at
Remarks Existing Absorption Trench Connected
with Splitter Valve. Existing Septic Tank in. in. in.
Decommissioned in Accordance with Pump make and model Electrical Inspections performed by
Municipal Code.
PIPE MATERIAL House to tank D3034Tank to D3034
Installer drainfield
Denali Excavating Drainfield D3034 CO/MT D3034
Inspector MEA BENCH MARK (Assumed elevation) 100.0 ft
Inspectiondctrt 8/9/16 2"d 8/916 Location and description
es:
3rd 8/10/16 4'h Lower Level Concrete Slab.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
Conditional Approval: Date a# V.-.e�r°••� q g
4*
®L 1 ee
49th c�a 1°.
® eeeee ee ... yF
e°e } eeee°aeeeasee°.w.s.ee.
e W B MICHAEL E. ANDERSON°°d 7
e 0 °°°°Z
ff
e i- No. CE-4/331
CSOOtg
®e.<eDjoy°.f. a`°! 4Approved t,�,(tc,� Date 5/3/ 17 ®1f1�ROFEss\o��4
Inspection Report_9-1-12.doc
m �
Municipality of Anchorage ..
Department
P.O. Box 196650 0 4700 Elmore Road
Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Division
On-Site Water and Wastewater Program .
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV161093 COSA#: Permit#: OSP161222
PID#: 015-134-18
Legal Description: Lakewood Hills#2 L22
Engineer: Anderson Engineering
Applicant: Larry Berry
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 30.0 feet.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
Waiver is Granted: X Waiver is not Granted:
Date: V/*�.6- Approved by: 49/41/4-7-
Name
9//y/H
Name of ReviewQf5
**** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE, USH! J ,
Community Development Department `\% Phone: 90743---904
Development Services Division Fax: 9 yt3 79 7>>>
On-Site Water & Wastewater Program �4 RUSH!
ON-SITE SEWER/WELL PERMIT APPLICATION - AUG 0 2 2016
RUSH! ` '5:5* ti
Parcel I.D. 015-134-18 1 t
Property owner(s) Larry & Helga Berry Day phone 346-2392 6 9 L a y
Mailing address P.O. Box 112230 Anchorage, AK 99511
Site address 7422 Whist Road Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Lakewood Hills #2, Lot 22
Legal description (Township, Range & Section)
Lot Size 72,800 Sq. Ft. Number of Bedrooms Five (5)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(Z all that apply)
Absorption Field Q Initial ❑ Single Family (SF) E
(w/wo ADU)
Septic Tank E Upgrade 0
Duplex (D) n
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑ r / r w i
1 t,,, k,„,, �
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: /
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: $1/0- VO Waiver Fees: >i'ZIS
Date of Payment: ?'" 1 —fib Date of Payment: g/9.h
Receipt Number: OHS, Receipt Number: D 47. .5
Permit No. OSP b/zZL Waiver No. OS V /670''3
Permit App_9-1-12.doc
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
NAM E ~/~ (~(~ ~/~ C~
MAILING ADDE~& ~:~)
LEGAL DESCRIPTION
LOCATION
[_.3PHONE--~NEW
,.~- 7(/0C:> / [] UPGRADE
NO. OF B~OOMS
Well ~ Absorption are_ar ~ Dwelling PERMIT NO~
Manufacturer ~ I Material J ~ ~ No, of c~partments
Liq capacty nqam]ons , nsde ength Wdth Liquid depth
( ~ F HOME--DE ~ I ~
DISTANCE T~-.JWell D~e,,ing PERMIT NO.
Ma~c-~r C/ ~ ~~aterial ~ '~quid capacity in ~Sllons
Well ~ - Foundation INearest lot line PERMIT NO.~>~ · .~
No. of lines Length of eac~i~ Total length of lin~ I Trench width ~ Distance between lines
Top ot ti~e to Tinisn grade Material beneath the ~ Total effective absorption area
Length Width Depth PERMIT NO.
Type of cri~ ) Crib ~e~ Crib ~ 'X I Total effective absorption area ~%
/ STANC TOWeU BuUding foundad ar t line
C ~ Depth Driller D~stance to lot line , PERMIT .
DISTANCE TO Building foundation Sewer line I S~tic tank Absorption area(s)
OTHER
SOl L TEST RATING
DATE LEGAL
PERHI]" NO.
BPPLiCBNT
LOC~TION
LEGAL
RR'¢I'"IF~ND HOLMEF.:
FERN ST
L22 LRKE[4OI-~F:, HILLS #2
LOT SIZE '3'399'3'2 SQUFIRE FEET
T'¢PE OF SOIL HE,.:,UF..FTI_i.~ S'¢STEM IS' TRENC:H
I"'lR;:-:: I MUM N_ ME. EF.. OF BE[:,ROFIMS
SOIL RRTiNG ,::Si_.]! FT,.."E:F.:)= dElO
'THE REQUIRED SIZE OF THE SOIL RBSORF'TION _-,.r_-TE.rl IS:
-- -- r-'-'--"" "~::'-- [:,EF"T~'4=
C"EF'TH= L:: L~ E P'~".7.~ T" H = 5:----: ._:~ F~. r~ -,-
THE LENGTH [:,IMENStON IS THE LENGTH (tN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF' R TRENCH OR PIT IS THE DISTRNCE BETHEEN THE SURFFICE OF THE
GROUND RND THE BOTTOM OF THE E',:-:;CWv'RTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRR',,,'EL BETHEEN THE OUTFRLL PIPE
RN[:, THE BOTTOM OF THE EXCF!VRTION (IN FEET).
F'ERMIT RF'PLICFINT HRS ]'HE RESF'ONSIE:ILIT"r' TO INFORM THIS [:,EF'FIRTMENT DURING THE
INSTRLLFITtON tN:SF'ECTiONS OF t=tN"r' NELLS Ft[:,JFtCENT TO ]'HIS FRLFEF. T'r FIN[:' THE
H_MEEF.' OF RESI[:'ENCES THFtT THE P.IELL NILL SERVE.
BRCKFILLING OF RN'¢ S'¢STEM NITHOUT FINRL INSF'ECTION RND RPPF.:OVRL B"r' THIS
[:,EF'RRTMENT HILL BE SUBJEC:T TO PF.']sEr_':UTICN
MINIMUM [:,!STRNC:E E,E.HEEN R NELL RN[:, RN"r' I]N-SITE SEHRGE [:,ISF'OSRL -,.,.-_TErl IS
100 FEET FOR R F'RIVRTE HELL OR .~RF~ TO 200 FEET FROM R FUBLI_. NELL DEPEN[:,ING
LIPON THE ]'b'F'E OF F'UE:LIC HE:Lb
'- - i-' '~ '
MINIMUM DI:,THN_.E FROM R F'RI',,,'RTE HELL TO R F'RI',,,'RTE _EHER LINE IS ~._ FEET RND
TO R ]:OMMI.tNIT'¢ SEHER LINE IS 75 FEET.
HELL LOGS FIRE REQUIRE[:, RND MUST BE RETURNED TO THE [:,EPRRTMENT WITHIN ]:0 [:,R'¢S
OF THE HELL C:OMF'LETION.
OTHER REQUIREMENTS MR'~' RF'F'L'¢. SPECIFICRTIONS RN[:, CC~NSTRUE:TION [:,IRGRRMS RRE
RVRILRE:LE TO tNSLIRE FRUFE... INSTRLI_RTION.
F"EF:~-I I T E.---.F I ~:E5 [. EL. EflE. EF- 3:A ..... 19:~:]::
I CERTIFY THRT
iL: I FIM FFIMILIFtR HITH THE REQUIREMENTS ,FOR ON-SITE SEHERS RND HELLS RS SET
FORTH 8'-r' THE MUNICIF'RLIT"r' OF BNCHORRGE.
2: I P.IILL. INSTRLL THE S"?STEM IN RCCORDRNCE HITH THE CO[:'ES.
S: t LINDERSTFtND THFtT THE ON-SITE SEP.IER SYSTEM MFt"¢ REQUIF-'.E ENLFtRGEMENT IF THE
RESIDENCE IS REMODELE[:' TO INCLUDE MORE THRN -'.': BEDROOMS.
S I GNED: ....................................................
FIPPL I CFtNT RF-t'¢MON[:, HE LMEF.:
V4. 0
¢'-~ "~%~ [~ SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERCOLATION
TEST
1
2
3
4
5
6
7
8
9
lO
11
12
13
14
15
16
17
18
19
20
DATE PERFORMED=
SLOPE
P
E
IF YES, AT WHAT
DEPTH?
Gross Net D~pth to Net
Reading Date Time Time Water Drop
,u o, slzq% q:sq Z m~. 2. ~lb-5'
q: 56 ~., ~O
m,oo 2,ff~ '20
+~zO ~slzsl~ ,o:o~ 3.00
Gp,~3
PERCOLATION RATE , (minutes~i ~ c~h~'~
TEST RUN BETWEEN ~ , FTAND /q 1/';~ FT
/--~WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological 8~ Geophysical Surveys
Drilling Permit No.
A.D.L. NO.
Io.lJBorough Subdi¥],io, Lot Block I-~].I '/4qtrs. Section No. TownshiPNo Range E~I M,ridion
_ DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS ~. OWNER OF WEL~:~
~d~: ~1 W. 5~ Ave.
Street Address end Area of Well Location ~ge, Aln~ ~1
Feet Belo~ 4. WE~L DEPTH: (final) 5. DATE OF COMPLETION
~. WELL LOG ~urfo~e ~t ft. 7, --
Material Type / Top Bottom
~y C~V O ~ 6. ~Cable tool ~Rolory ODriven ~ Dug
~d & s~t 1~ t63 Typ,: O~ ~
~o. STATIC WA~E. LEWL:
~ ~ Above or ~ ~elow tend surface
Equipment used:
f~. after hrs. pumping g.p.m.
ft. otter hrs. pumping ~g'p'm'
I~.GEOUTING Well Grou~ed: ~ Yes ~ No
Malarial: ~ Neat Cement ~ Other:
I~. PUMP: (if oveiloble~ HP
Length of Drop Pipe ~ft. c~poclty ~g'P'm'
0 Subm. ~ Jet 0 CentrifJc,[ ~ Other
16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Wot~r Temperature ~_o 0 F 0 C
Form
~uthorlzed Reprbsentalive
Copy Distributlom; WHITE-State DGGS, PjNK-Ori{ler, CANARY-Customer
? APPLIC FILLS OUT UPPER HAl. .... 'ONLY
Buyer
Address Zip Code
Lendin~ Insti~uHon Phone
Address b~,~.W~¢[O~[ j~< Zip Code
~ Phone
Realty Co. & A~nt
Address Zip Code
LeoalDescript[on [_:)¢ ~ ~ ~ L~,~e~od (q(Us ~
Type of Resi~nce
~- Single Family
~ Multiple Family No. of Bedrooms ~
~ Other
Wster Supply
~/ ~/~, A~ACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
D
Individual
~'~t',~ ~ ~~ For wells drilled prior to that date, give well depth (attach Icg if available).
Community
~ PuNic Utility
Sewer Disposal -7 ~
~ Individual Year Individual Installed: ~
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEPORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Da,e Date Da,e
Inspector Inspector Inspector Inspector
F'e d Notes: ~ -/~ ,0/9 ~C~'_~. ./~..~ ~ · MUNICIPALITY OF ANCHO~GE
' . C~ ~ ~ ENVIRONMENTAL pROTECf[ON
('~PPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) OON~TIONAL APPROVAL'
Soils Rating Date ~wer Installed Well To Absorption Area /~ ~-~ Well Log Received
/ ~ ~ ~ ~
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COSA Checklist.docx
COSA Checklist
Legal Description: LAKEWOOD HILLS #2 LOT 22 Parcel ID: 015-134-18
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 7/15/1983 Total depth 192 ft
Cased to 192 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 5/7/2024
Static water level at beginning of test 154 ft.
Well production at time of test 5.7 gpm
Water storage tank volume NONE gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 9.52 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 5/7/24
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 49”
Date of pumping 5/7/24
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/10/2016
ALL standpipes present per record drawing
Total measured depth from existing grade 7.8 ft (max)
Measured depth to pipe invert from grade 3.7 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective. (ED)
If not, state depth into effective 3.4’
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 5/7/24
Results Pass (TESTED NORTH - NEWEST TRENCH)
Fluid depth prior to test 10 in (Including missing 7”)
Water added 800 gal
New fluid depth 16 in (Including missing 7”)
Elapsed time <15 min
Final fluid depth 10 in (Including missing 7”)
Absorption rate 750 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 48 in (MOA 4’ ED)
Effective depth used 10 in (Final Fluid Depth & Missing)
Effective depth (ED) remaining 38 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots &
appears approximate with 0.6’ OR 7” of ED missing. Older southern trench had 5” of standing fluid.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 5/31/2024
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
5/31/24
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WHIS T ROAD
N 89 56' 30" E 280.00
SO
THESURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE
OWNER OFRECORD AS OF THEDATE OF THIS SURVEY.
ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS
WRITTEN PERMISSION IS PROVIDED.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHON ANY
CONFLICTS BETNEEN EXISTING STRUCTURES AND PLATTED LOT LINES ANDIOR EASEMENTS; AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHONN
HEREON ( UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAYING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHONN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNON ANDAOR ICE.
OF A��9��4
CP
49 TH*
SHANE A. HOLT
ie LS -6914
Qw a
��\,°fessional Lo
AS-BU/LT SURVEY I" =30'
NO CORNERS SET THIS DATE
I HEREBY CERTIFY THA T I HA VE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 22 LAKEWOODHILLS2
A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLEIMPROVEMENISStTUATED THEREON AREWITHIN
THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED ATANCHORAGE,ALASKA THIS 29 TH DAYOF
MA Y _2024
HOLT LAND SURVEYING
9309 GROVER DRIVE
16066237-16 ANCHORAGE, AK 99507
223-8615