HomeMy WebLinkAboutLAKEWOOD HILLS #2 LT 20A-2Lakewood Hills
#2
Lot 20A-2
#015-134-97
Municipality of Anchorage Page 1 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: S D / D I.i I PID Number: 015-134-20
Name: MIKE SHARROCK
Wastewater System: ❑ New ■ Upgrode
Address:
10001 HILLSIDE DRIVE ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone:
(907) 346-4442
No. of Bedrooms:
6
■ Deep Trench a Shallow french f] Bed 0 Mound OOther
LEGAL DESCRIPTION
Sat+ Rating:
0.8 Ft.
Total Depth Nor„ o.:s.wl shear
10.83 MAX Ft.
CPO/Sq.
Lot: Block: Subdivision:
Depth to p« Wit" Iron 069or0l swan:
Goal Depth be th ppe:
20A — LAKEWOOD HILLS #2
1.6 MAX Ft.
9.2 Ft.
Township:
-
Range:
-
Section:
-
So oddee etw« en9'"al shone:
Gaal Iargth.
65'
SEE DRAWING n.
Ft.
Dora width:
Nvntwh of war
owtonc. atwea" ww:
WELL: ❑ New ■ Upgrade
2.5 Ft.
1
— Ft.
clawhcatwn (pt., A6.c):
fatal Depth:
co«a To:
Total obw vptbn a«:
P.pe ^Mena°
ASTM D -3034/F-810
PRIVATE
400 rt
282 n.
1196 so.1t.1
onar:
Dote Draw:
st.lKwatH Leal:
Imtow:
CATS EYE
Data Iwtaad:
9/29/99
M -W DRILLING
8 13 99
250 n.
Ywld:Pamp
Set /4:
Ga,.rd:
Cow+q ho9ht "'a"'
TAN K
2-3 cpu
UNKNOWN n.
18"+ n.
SEPARATION
DISTANCES
■Septic 0Holding 0 S.T.E.P.
To
Septic
Absorption
Lift
Holdingblit/pivot.
Nohwtoctuhe:
ANCHORAGE TANK
Capacity in We"*:
2000
From
Tank
Field
Station
Tank
S.«r Lias
Well
100'+
too'+
-
-
25'+
wt.na: STEEL
N, e. a eo"go w"tw.
2
Surface
too'+
too'+
-
-
-
LIFT STATION
Water
Lot—
&?a in pollens:
leol«IIYa:w
Line
5'+
10'+
—
—
P
awp en level at: vmp al
,tph wata atan ot:
Foundation
s'+
10'+
—
—
—
Curtainpvnp
lbws
ENctnca khpectanw palam.d hr:
Drain
NONE KNOWN
BENCH MARK
Remarks:
L«atwn eM Dewcnptwn:
TOP OF STAIRS ON DECK = 140.62
TH#1 & TH Q2 DRY ON 9/23/99 TO 16' & 17'.
BOTTOM OF SEPTIC TANK = 127.94
MwmaA ENvolion:
OLD WELL WAS ABANDONED 8Y M&W DRILLING.
Ft'
ENGINEERS 111 A
OLD SEPTIC TANK WAS ABANDONED PER UPC (PER CATS—EYE).
000600
000
..
Inspections performed by: AWWC, INC. Dates: 1st 9/23/99
....... .. ............
2nd 9/24/99
Q Q
3rd 9/27/99
'. J f y Ga ss;
0
Department of Health and Human Services approval
�4a� J! 7x53
Dater
04p°prones'*1*°^°oma
Reviewed and approved by:
040poo�a
n-els R«. 9/91) Nos 25
ALASKA WATER & WASTEWATEH
CONSULTANTS, INC.
May 16, 2001
Municipality of Anchorage
Development Services Department
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Septic System Documentation for Lakewood Hills #2, L20A
To whom it may concern:
AWWC, Inc. was retained by the property owners in1998 to design a septic system for a
proposed triplex on the subject lot. A design package was submitted to ADEC (copy of the site
plan and soils logs are attached), however, approval to construct was withheld until issues were
resolved with the water well and a requested waiver. AWWC, Inc. applied for, and received
approval to construct a new class C well on the property (See the attached ADEC letter dated
2/26/99). It is our assertion that DEC engineer, Steve Pettis, then gave us verbal approval to
proceed with the installation of the septic system. We have discussed this issue with Lindy
Benabdelhak (269-7517) at ADEC, who then discussed it with Kevin Kleweno, P.E.. Given the
confusion, and missing paperwork (specifically the certificate to construct the septic system) Mr.
Kleweno requested only that we submit a copy of the as -built drawings to his department.
The property was never converted to a triplex and is currently being sold. Based upon the
information provided (well log, septic system as -built drawings, water samples, HAA
paperwork), we are requesting that you issue an MOA health authority approval for the subject
property as a six (6) bedroom single family dwelling.
If you have any questipns, please contact me at 337-6179.
.E., M.S.
C.C. ADEC, Kevin Kleweno, P.E.
6901 Debatr Road, Suite 2-B • Anchorage, Alaska 99504
Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.com
301SI�IH
iN3YOSY3
1�40ckl3
0
TH12
ALASKA WATER AND WASTEWATER CONS C.
6901 DEBARR ROAD. SURE 2B. ANCHORAGE, AK. 99 c
PHONE: (907) 337-6179/FAX: (907) 338-324
LE OESCRIPAON: '
LAKEWOOD HILLS SUBDIVISION /2. LOT 20A •
TY OF WORIQ ,
....... . ..........
DESIGN OF SEPTIC SYSTEM UPGRADE .... ....
PI r FOR: , ' , PHONE - NBE7tol a rey or e .
JOHN E. RYAN C/0 PAT SHARROCK 27 5985 QQ , '• 953 •
`o
DRAWN BY: PAGE: '. •'•••••••• f'co
ir 11/20/98,, A.C.G.. 1 100' 2 0F dProffs oOc v
W
W
0
J
J
no
\ oosTrw 9
I BEDROOM
\ SWE-fANIY
D6'E1DND
NOTE OLD WELL \ — �•' �•+
DONEO
II
�TH11
„y2 • �TES'T NOUS I
DREDM V.
ALASKA WATER & WASTEWATER SCALF- C.J.G.
CONSULTAN6901 DEBARK ROAD. WTF 29 • ANCHORAGE. Am 99506 SA41rE 907)337!179 • FAX 9071336-3246 1" = 50'
REPARED FOR: PHONE NUMBER: PAGE NUMBER:
MIKE SHARROCK (907) 244-5085 2 OF 3
EGAL OESCRIPDON:
LAKEWOOD HILLS SUBDIVISION #2; LOT 20A,
YPE OF WORK
AS -BUILT DRAWING OF SEPTIC SYSTEM AND WELL UPGRADE
Comess:
OCT
SQL
... '• ec4v
WAS ARAN
BY NkW
ON 8/90
i
F120.5123.4
I
n+! 1TH
2
tt
C01 18.1
81.0
MTl 12.4
57.8
CO2 82.7
9.3
MT2 58.1 1 8.0
A
8
C01 225.3
242.2
MTl 224.2
241.4
M7 77l (1
7lA 9
II
�TH11
„y2 • �TES'T NOUS I
DREDM V.
ALASKA WATER & WASTEWATER SCALF- C.J.G.
CONSULTAN6901 DEBARK ROAD. WTF 29 • ANCHORAGE. Am 99506 SA41rE 907)337!179 • FAX 9071336-3246 1" = 50'
REPARED FOR: PHONE NUMBER: PAGE NUMBER:
MIKE SHARROCK (907) 244-5085 2 OF 3
EGAL OESCRIPDON:
LAKEWOOD HILLS SUBDIVISION #2; LOT 20A,
YPE OF WORK
AS -BUILT DRAWING OF SEPTIC SYSTEM AND WELL UPGRADE
Comess:
OCT
SQL
... '• ec4v
PERMIT NUMBER: AS -BUILT DRAWING PARCEL NUMBER:
FINAL GRADE
138.2 - 137.5
5t1 512
TOP OF TANK
TOP OF TANK ® OUTLET- 132.79'
INLET— 132.83'
INVERT OF BUNG
INLET— 132.31'
NSW 2000 6&LON I I
%P,nC TANK INVERT OF BUNG
OUTLET- 132.04'
80TTOM OFA
TRENCH a 89.25
ALASKA WATER & WASTL'WATER
CONSULTANTS, INC.
6901 DFRARR ROAD. SUITF 28 • ANCMORAGF. M 99SM • PN F (907)337.609 • FAX (907)338-371
PREPARED FOR: PHONE NUMBER:
MIKE SHARROCK (907) 244-5085
LEGAL DESCRIPTION:
LAKEWOOD HILLS SUBDIVISION y2; LOT 20A,
TYPE OF WORK:
PROFILE AS—BUILT OF SEPTIC SYSTEM UPGRADE
FINAL GRADE
102.8 (AVG.)
ORIGINAL GRADE
100.04-100.98
INVERT OF PIPE
98.45
MAX TOTAL DEPTH
BELOW O.G. - 10.83
'10/2001
o pr
.......
-N%
............
BY:
C.J.G.
QQQ
NUMBER:
3 OF 3
'•, f e
Gorness.
0o
7953
NJI
03/23/1999 12:00 3453287 M W DRILLING, INC PAGE 01
- M•W DRILUNG, Ino.
' P.O. a" 110676 a 1*"0 OW aawd mve av
(907) s4HM
ANCHOPAOL ALASKA 09011
a�143-F:1:17aTel,
Location (address of: Township, Range, Section, if known; or distance main road
rnr Jnh. r.kXr wnnn HIr.T.4y/n� M9• 1nnn1 urr.v.cn TF. no
ANCHORAGE. ,A,)5,,, --
Sias of casing . -6 u Depth of Hota 5 D 0 feet Cued to 2 B 2 fsu
Btatk: water W& a a0 k• tbelow) land surface. Finish of well (check one) open end ( );
screen ( ): Perforated ( X ).
SVA.
Well pumping test ate. itnl.a pe} ftW* (mtnute) for -1 --hours w1t1:.100% ft
of drawdown from static lavel.
DateofcompleNlon 13 AUG139T 1929_
WILL too
Depth in feet from
ground surface Give drtalla of formations perutraW. size of material, color and hardness
0
TO 2
2
TO 32
3_ 'ATO 42
42 TO tie 4
134
To 196
196
232
232
201
,ip 261
To 270
27UTO
28v
230
Tp 36i
,nn5 To 3b7
367 TO 400
TO
TO
.MEDIUM GRAVEL: SILTY
SAND: SILTY
GRAVELt BROWN, SILTY
GRAVEL: SANDYf WET, 3 GPM
CLAYt SILTY
BEDROCK: GREEN WITH WHITE LENSES, GNALL WATER a'EAPS I•
SPORADIC FRACTURES
UoI=CONTRACTOR
puaLf�
'/61
s
v
M
R
m
Cc TF 1
DEPT. OF ENVIRONMENTAL CONSERVATION
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER and WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
http://www.state.ak.us/dec/home/htm
December 14, 1998
;1 1 TONYKNOWLES, GOVERNOR
Telephone: (907) 269-7521
Fax: (907) 269-7650
Jeffrey A. Gamess, P.E.
Alaska Water & Wastewater Consultants, Inc.
7320 East Chester Heights Circle
Anchorage, Alaska 99504
Subject: Lot 20A, Lakewood Hills Subdivision #2, Anchorage, Alaska, Septic System
Upgrade to Multi -Family Use, ADEC Project Number 429, Domestic Wastewater
Plan Review.
Dear Mr. Gamess:
This letter is in response to your submittal received in this office on December 7, 1998 requesting
construction approval for a replacement septic system on the above -referenced property. The
domestic wastewater disposal system is proposed to serve a 6 bedroom, single family dwelling
that would be converted to a multi -family dwelling in the future. Your request to approve the
wastewater disposal system for multi -family use would require waiving the 75 foot separation
distance between the existing private well and the replacement sewer service line.
Since 1985, this Department has delegated plan review authority to the Municipality of
Anchorage for single family drinking water and wastewater systems. The Department is
requiring submittal of plans to upgrade the entire property to a multi -family dwelling before the
Department will consider the required separation distance waiver.
Attached is a checklist of submittal items required for a Class C Public Water System plan
review.
State regulations have been modified to require fees for plan reviews and waiver requests. The
fee required for this project is $200 for the drinking water system review, and $230 for the
separation distance waiver review. These fees are in addition to the $295 already submitted for
the domestic wastewater plan review.
Jeffrey A. Garness, P.E. -2- December 14,1998
Thank you for your cooperation with this Department. If you have any questions, please contact
me.
Sincerely,
Steven A. Pettis
Env. Eng. Asst. II
cc: Jim Cross, P.E., MOA/DHHS, w/o end
m
- \V
-----;/1\ F
I I
A
y
I\ \ wR9.0 Rmw. R]UWW�
Gfµ-0I11. DKMC w C�pICT[
/ W
al \
�o
--
�P'� TQf Naa
nRrowcR
I r oncocRr r
rinr.9., r[.
PRoposm }IIDem J
u• umI w I", 0DR
h+x) W 9A• wo[ wIH
IF a RE,w.XEWDR DIV
I91aIm
NOTE:
PRIOR TO DRILLING THE NEW WELL THE DRILL ••
ER e• I VERIFY TKAT THERE ME NO SEPTIC
SNSTENS WITHIN 130 FEET OF THE PROPOSEp WELL LOCATION. NO YOB OR ADEC RECORDS
COULD BE FOUND FOR THE SEPTIC SYSTEM ON THE IAT TO THE NORTH.
I 9n I.
1) M WNwM011 9W11 Nw[ M
9/SI �� LK MOM 190' RRL
L1RM.1011 wwR m•W�611RKIIpi�
9) M RIRIfN t m r w9i.1R{p ►IA49A.
m M kan9 TanaRn
ALASKA WATER AND WASTF.W
rn1TTCTTTTAPTTc TTT!`
iffA
mne TNaf
4 CRIbN
D—�I/ITN ioa
RPM TMOIC
eD1RI m
USE M
wits A
ALASKA
READING
WATER & WASTEWATER CONSULTANTS, INC.
F
DRY
10/30/98
7320 E. CHESTER HTS. gRC1E •ANCHORAGE. AK. 99504
P.`�, ••
,900
(INCHES)
11/2/98
PERC. H
PHONE ( 7) 337-6179 •FAX (907) J36 -J246
,�X�0
O
1
SOIL LOG — PERCOLATION TEST
6•
—
2
3:47 30
+ ::
4 3/4•
LEGAL
DESCRIPTION:
LAKEWOOD HILLS SUBDIVISION /2. LOT 20A.
••••• • ' ' .•
•••• '"".•...
PERFORMED
4
FOR: JOHNNY RYAN
......•
J f A. UO e88
DATE
PERFORMED:
10/30/98
Q(�A E-7953
OEM
rest
—
TEST HOLE #1]
.,� •p............
–4=4�-- -- 30
7=
4 1/2•
==_=
---
ORG/LOAM
°r...w�
2
SOIL CLdSSIFICATIONS
•
#i#
GW Z.'. _ :: DRG
-
3
;iI !t
• .. GP I
MLw 0 EXISTIN C61
w GM
SW MH
5-'
SM •''•" SP CH \
r
#!
SILTY SAND W/ 1 + SM OH \
LIGHT GRAVEL SC
7
DEPTH TO' DATE
GROUNDWATER
THO
} } I2
i
9
}
{!1•
SITE
TH/2�
—
�}
00
10
; kilt
r _
11
., ,
. �0 ,.
'' • 'LIE '
IS TIES
12
13
'' ' ''
....•
:
;: .
;t;
SP
14
'' • ''
::•: ••
15
'••'
.... �.
..•.•.
B.O.N.
17
ie
19
PERCOLATION RATE 6.7 (MINJINCH) PERC. HOLE.DIA. 6 (INCHES)
20'
TEST RUN BETWEEN 5.5 FT. AND 6.0
FT.
COMMENTS:PERFOMED'BY
ALASKA WATER do WASTEWATER I,
CERTIFY
THAT
THIS •WAS PERFORMED
IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS -
DATE.
DATE:
DATE
READING
WATER LEVEL
DRY
10/30/98
-'
15
11/6/98
DATE
READING
CLOCK NET TIME
WATER LEVEL
NET DROP
TIME (MINUTES)
READING
(INCHES)
11/2/98
PERC. H
WAS PR ED 5 HOU
PRIOR TO
NG
1
3:17 —
6•
—
2
3:47 30
1 1/4•
4 3/4•
3
3:47 —
6'
—
4
4:17 30
1 1/2'
4 1/2•
5
4:17 —
6•
—
–
- 6---
–4=4�-- -- 30
1 1�2�
4 1/2•
A'LASSA WATER & WASTEWATER CONSULTANTS INC.
J20 p{EST�A dRd.E ' ANCHORAGE AX. 99504 P O�
PHONE (907) 35%l79 • FAX (907 Jia -3246
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LAKEWOOD HILLS SUBDIVISION J2. LOT 20A ••• •••• ..•.
PERFORMED FOR: JOHN E. RYAN ••• • •• • •• ••• ••••••
A. Go sa;
DATE PERFORMED: 10/30/98 e ey & !y C Go `
gt _ __ TEST HOLE #2 •^,'''
_--- pyo
ORG/LOAM
2—i • SOIL CLASSIFICATIONS
Q : o GW r _ : ORG \
3 + GP IML Q ExisnN c
hilU GM CL �• u
4 : GC OL
SW MH
SP CH
• SILTY SAND W/ S1 ' OH /
8 LIGHT GRAVEL SC
I
7 TH# I
8 ,
i
TH/2+ /
9 ! SITE PIAN L —
t 1• ' 1 '
10 .
I
•1
11 • • ,•
12
13 •'•'•
SP
14
...•
15 •' ••••
17 B.O.H.
18
19 PERCOLATION RATE N/A (MINJINCH) PERC. HOLE DIA. 8 (INCHES)
20
TEST RUN BETWEEN N/A FT. AND N/A FT.
COMMENTS: WEST TEST HOLE
PERFOMED BY ALASKA WATER do WASTEWATER I, CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE. DATE:
DEPTH TO DATE
GROUNDWATER
DRY
DATE
READING
_
----fig'—y.—
10/30_/98
11/8/98
WATER LEVEL
READING
NET DROP
(INCHES)
DATE
READING
CLOCK
TIME
�T TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
_
E._TEST
PERCO
_HOLE�1
TION DA
FOR
j' • 'I Municipality of Anchorage
On -Site Water and Wastewater Program
``- (907)343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 015-134-97 Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lakewood Hills #2; Lot 20A-2
Location (site address) 10001 Hillside Drive *Anchorage 99516
Current Property owner(s) Marcia Templin
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
nX
4. TYPE OF WATER SUPPLY:
❑
Individual Well
❑
Individual Water Storage
❑
Community Class _ Well
❑
Public Water System
❑
WaiverNariance request for: N/A
Day phone 632-2317
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual
nX
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by:
COSA to be releas d to the engine4, u ess otherwise requested by the engineer.
COSA Fee $ 25 z -1O
Date of Payment 3 —04C.,
Receipt Number Qq 12 L G
COSA # d Sc I tog
Date:
Waiver Fee $
Date of Payment
Receipt Number
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 Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179
Address 3701 E. Tudor Road, Suite 101, Anchorage AK 99507-1259
Engineer's Printed Name Jeffrey A. Garness Date ! �7, �l �
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic
system in accordance with the guidelines and regulations established by the Municipality of
Anchorage and industry practices. The reported results describe the condition of the system/s on the
date/s of the evaluation. Separation distances were measured to readily identifiable features.
Hidden defects or encroachments may exist that were not identified during the evaluation. The
operational life of all wells and septic systems depend on a variety of variables including, but not
limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of
construction (materials and workmanship), and the water usage of the family utilizing the system/s.
These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the systems; therefore, GEG makes no warranty (express or
implied) regarding the future performance ofthe well or septic system. GEG makes no
representation whether an alternative well or septic system can be installed on the property in the
event either of the current systems fail. The content of this report is for the sole benefit of the
person/party who retained GEG. Reliance upon the information provided in this report by any other
person or party, including but not limited to subsequent property purchasers, is not authorized. In
short, GEG disavows any legal duty to anyone other than the person/party who paid for this report.
6. DSD SIGNATURE
System #1 Approved for `J bedrooms
System #2 Approved for
Disapproved
Conditional approval for
M
bedrooms
bedrooms, with the
OFgNC .,
j� ON-SITE
WATER AND
m WASTEWATER Cl)
g ipu[?O ;RAM mac:
10., O�
Original Certificate Date:
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 engineers work.
7. ATTACHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 9.1-12Aoc
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: LAKEWOOD HILLS #2; L20A-2 Parcel ID: 015-134-97
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 8/13/99 Sanitary seal (Y/N) YES
Total depth 400 ft. Cased to 282 ft.
FROM WELL LOG
Date of test 8/13/99
Static water level 250 ft.
Well Log (YM) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 18+ in.
AT INSPECTION
3/2/16
221.3 ft.
Well production 2-3 g,p,m. 1.7+
g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate 7.01 mg./L. Collected by: GEG. Ltd,
Arsenic: NO ug./L. Date of sample: 3/16
B. SEPTIC/HOLDING TANK DATA 'PER 2001 HAA FCO IS LOCATED IN GARAGE (SEE ATTACHED PHOTO)
Tank Type/Material SEPTIC/STEEL Date installed 9/23-27/99
Tank size 2000 gal. Number of Compartments 2
Foundation cleanout (Y/N) *1 ESES Depression over tank (Y/N) NO
Cleanouts (Y/N) YES
High water alarm (YIN) N/A
Date of pumping 3/3/2016 Pumper NORTHLAND PUMPING
C. ABSORPTION FIELD DATA *6ELow ExIs11NG GRAD
Date installed 9/29/99 Soil rating (g.p.d./feo /bd 0_8 System type DEEP TRENCH
Length 65 ft. Width 2.5 ft. Gravel below pipe 9.2 ft.
Total depth *13.6+ ft. Eff. absorption area 1 196 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 3/2/16 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth in absorption field before test 14 in. Water added 832 gal New depth 19 in.
Elapsed Time: 120 min. Final fluid depth144 in. Absorption rate >= 750+ g,p.d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date —
2000+ GALLON PRE—SOAK WAS PERFORMED ON 3/1/16
SEE ATTACHED PHOTO SHOWING SETTING OF TESTHOLE NEAR THE DRAINIELD
SEE ATTACHED EMAIL REGARDING SOIL COVER OVER DRAINFIELD
D. LIFT STATION
Date installed
Size in gallons Manhole/Access
"Pump on" level at in. "Pump ofr
E. SEPARATION DISTANCES
water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot
100'+
Public sewer main
75'+
Sewer /septic service line
25'+
Animal containment areas
50'+
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
Holding tank
Manurelanimal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water, 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
SEPTIC TANK IS LOCATED UNDER DRIVEWAY; IT DOES NOT APPEAR TO BE PART OF THE MAIN
DRIVEWAY AND IS ASSUMED TO BE A "PULL OUT" SECTION; IT IS NOT RECOMMEND TO DRIVE OR
PARK OVER THE SEPTIC TANK
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 Name JEFFREY A. GARNESS
Date 317-4/G
(Rev. 11/05)
Municipality of Anchorage o pGE sG,
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC161084
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
20A-2 of Lakewood Hills #2 subdivision. This inspection revealed a nitrate
concentration of 7.01 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/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.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
David Garness
From:
'Marcla Templin <marcia.templin@gmail.com>
Sent:
Friday, March 18, 2016 11:37 AM
To:
David Garness
Subject:
Re: Lakewood Hills #2; Lot 20-2A
David,
We have lived in the home at 10001 Hillside Drive (Lakewood Hills #2; Lot 20-20A) since 2001. We never
experienced any freezing problems with the septic system - it performed flawlessly.
Regards,
Marcia Templin
On Fri, Mar 18, 2016 at 11:30 AM, David Gayness <David(a�garnesseneineerine.com> wrote:
Marcia,
The MOA issued a comment sheet regarding the COSA for the subject property. As we talked about
previously there was a deficiency regarding settling of the testhole near your drainfield. Per conversation with
Tim at the MOA on-site department on 3/18/2016, we need an email or letter from you stating that you have
not received any freezing problems. In short, if you would please respond to this email stating that you have
not had any freezing problems with your septic system, the MOA will approve your COSA. If you would
please give me a call if you have any questions, thank you.
David J. Garness, EIT
Consultant
Garness Engineering Group, Ltd.
3701 E Tudor Road, Suite 101
Anchorage, Alaska 99507
Phone: 907-337-6179
Fax: 907-338-3246
Website: www.gamessengineering.com
i
1
Lot 4
1
I
/
I
20' UTILITY EASEMENT
i
/
N 89'56'00"E 280.15'
z
10.1'02.1' SHED rn
—
DECK RAOIUS
V
{
PROTECTIVE
3.0'x13.3° CANT
ASPHALT WELL
DRIVEWAY
8.0'02.0'I
GREENHOU`.
tib
N
I
\ 1.2' CANTS as^
2 STORY
RESIDENCE w/
re FULL BSMT.
\
'.,�
RETAINING
S
9'56100"W 90.0
'' j
WALLS
I
I
tiR
X
PORCH''.'
CONCRETE
,:
GRAVEL•
PATIO
DivEWAv
i
=
I
F—
i
SEPTIC PIPES
' r
I
U)
I
z
I
I
Lot
20A-1
m
1
(
v
1
0
;0
I
I
m
I
I
,LA�
co
...
N 4456'00"E
21.21'
I
1
I
N 45'04'00"W
21 21'
SEPTIC PIPES Z
Lot
20A-2
0
a 1.82
Acres
I
I
I
0
I
I
I
I
I
I
o
I
-1----------------
"W
I
t
I
S 89.50'21
99.82'
f
I
I
1
�
Lot 21 A
PLOT PLAN _ AS BUILT X SCALE 1" - 50' GRID SW 2540 Project No. 16-060/AII
Lot 5
Lot 1
6.2'x16.2' SHOP
Lot 2
T&E EASEMENT
Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 49515-3049
(907) 522-6476 Phone
Registered Land Surveyors (907) 522-4625 voxes' F A��aq
kenOlangsurvey.com / jonathanOlangsurvey.com
I hereby certify that I have surveyed the following described props�Q •. S��oo
LOT 20A-2, LAKEWOOD HILLS #2 (PLAT 2001-93)j
Anchorage Recording District, Alaska. and that the Improvements situated thereonare ........ .:....
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, fronamisalon lines o- 3ther visibler KENN G. ...
easements on said property except as indicated hereon.Qr 41. Imo;
Dated this the VD S 520
Day of h1pRrv� 2��,:•_, at Anchorage, Alaska i• �•'
It is the responsibility of the owner to determine the existence oz any easements, a0 �� L
covenants, or restrictions which do not appear on the recorded subdivision plat.
Lot 3
MONUMENTATION
N 89°56'00'E M2
50.00' (R a M) pNOYt 3NlJb
NETTLETON p
SUBD. J
i I B/OINT UNSUBDiVIDED 12N4R3W � Q�fSt4
61
4 I M1 I N ss°56'00'E 280.00' (R) M5 SEE NE CORNER DETAIL A. 513 �oO\�
iV
.. N 69156'00'E 280.15' (M) — — _ �f4tt992S �D N p CEN
k 10 H/B INT s/A JO 1N
1 FOUND 2 1/2' BRASS FOUND 2 1/2' BRASS
N 20' UTILITY EASEMENTS Q� CAP MON 30 FEET CAP MON. 1.0 FOOT
I ?' BELOW GRADE IN BELOW GRADE IN
0 S I I MON. CASE a MON. CASE
I < 1 N �9°56'00' ZOA�2 Lot i M3 M4•
v 79.149 s.t. dd
m 1 saaoM3 S9S° 1.817 AcresOOD yEWOOD(2? 1 m �19 U) I v' I z i •`'�`^ 20A-2 2OA-2
I W 8. $$ 1 w92DA-1l
2OA�
1 08 89 I N MSI. O� 83 Z 5202-5 5202-S
f f 20A-- t 8 0; ^`" 2001 2001
N '-� tp V s
--I I ON NN I 67.355 s.t. io na a� 2 1/2' ALUM. CAP ON 2 1/2' ALUM. CAP ON
J 1 W o g o 1 1.551 Acres - g g 80 Lor 2 Z 2 1 /2' x 30' ALUM. PIPE 2 1 /2' x 30' ALUM. PIPE
_ r.i �^ z Q SET FLUSH WITH GROUND SET FLUSH WITH GROUND
Z S 44°56'00'W 1
I � 1 2121' I o Q 1451- YELL"
MAMC C"
Z.
1 8B I G3°'I I S 4z0.24'C,O"E 1 �— — ODONL � a'W
� 1 u, _ y
Z REF 10
Q I 3 I z = MON NW K® L
Q 1 1 $ i Coft
Let 3
q 9�j �q B/B INT m FOUND I' STEEL PIN sG 1'085S 6 -s
a60 "J (j V" I 50.00' 180.00 99.82') ��' MON � SLT AT ALL
CORKM NOT
0�—RECOIST w I S 89°50'2t'W 279.82' (M) FOUND 3' BRASS CAP MON. OTHUTWME
S 89°58'00'W ZBO.00' (R) I 10' TELECCMMUNICAMON FLUSH WITH GROUND ocscRM
Gate
ENT
1 8A Q FOUND I' STEEL PW 1 (DEDICATEDND ELECTRICAL
BY THIS PLAT)
off: /3 M I I I SEE SW LOT CORNER DETAIL
Ti*ne_.__ J
.�— �
UNSUBDIVIDED
Requ¢¢ted ByLot 21A
M2
1) ACCESS 15 LIMITED ON HILLSIDE DRIVE TO A
COMMON DRNEWAY FOR LOTS 2OA-I AND 2OA-2.
2) THE EXISTING SEPTIC SYSTEM ON LOT 20A-2
FALLS WITHIN THE 10' TELECOMMUNICATION 8
ELECTRICAL EASEMENT DEDICATED BY THIS PLAT
ALONG THE EAST BOUNDARY AND IS NOT
CONSIDERED AN ENCROACHMENT. REPLACEMENT
OF THIS SEPTIC SYSTEM WITHIN THE EASEMENT
IS NOT ALLOWED.
'S CERTIFI
LEGEND
® - MONUMENT (SEE MONUMENTATION) 01,
OTHER MONUMENTATION (AS DESCRIBED)
(R) -RECORD (PER PLAT No. 71-314)
(C) COMPUTED (FROM PLAT No. 71-314)
(M) MEASURED
B/D INT BEARING /DISTANCE INTERSECTION
-BEARING / BEARING INTERSECTION
X - NOTHING FOUND OR SET
1, Kenneth Lang, Profes!s1!?tjaKand Surveyor, do hereby certify that
THIS is a true and correct roprosentation. of
lands actually surveyed and that the distances and bearings are shown
correctly and that all permanent exterior monuments, all other monuments
and tot corners have been set and staked, or if final completion is assured
by subdivision agreement, they will be set as specified in sold subdivision
agreement.
Lot comers set by: N/A
Monuments set by: N/A
PLAT APPROVAL
Plat approved by the Municipal Platting Authority
this -'2 -,tL day of TJI-. 20-9 � I. J, Y40L
L
ui torficial
APPROVALS os
Platting Officer
Munieipcl Surveyor 7
Environmental Protection`f�G 4�`, t
Lot 20A -I
STEEL PIN FOUND
HELD FOR SEARING
r— INT ,
SW CORNER DETAIL
NO SCALE
TAX CERTIFICATION
OF�% All real property taxes levied by the Municipality of Anchorage
A (!�� on the area shown on this plat have been paid in full, and if
Q : approval is sought between January t and the tax due date, there
is on deposit with the chief financial officer an amount sufficient
to pay estimated real property tax for the current year.
•.XENNE a.
A t.ANO,horized Official Date
V
LS -5202
ACCEPTANCE OF DEDICATION
CERTIFICATE OF OWNERSHIP AND DEDICATION
I (we), hereby certify that I (we) hold the herein specified property interest
In the property described hereon. I (we) hereby dedicate to the Municipality
of Anchorage all areas depicted for use as public utility easements, streets,
alleys, thoroughfares, parks, end other public areas shown hereon, a slope
reservation easement sufficient to contain cut and fill slopes of 1.5 feet
horizontal for each 1 foot vertical (1.5 to 1) of cut or fill for the purpose
of providing and maintaining lateral support of the eonstruMod streets.
Thera to rocervod by the grantors, their hairs, successors and assigns, the
right to use such areas at any time upon providing and maintaining other
adequate lateral support, as approved by the Municipality.
I (we), hereby agree to this plat, and to any restrictions or covenant
appearing hereon and any such restriction or eaveng t hall be binding and
enforceable against present and succeasi",,owners//,f subd!ded prop�rfy.
MICHAEL G SSH'ARROCK DANA L. SHARROCK
10001 HILLSIDE DRIVE 10001 HILLSIDE DRIVE
ANCHORAGE, ALASKA 99516 ANCHORAGE, ALASKA 99516
(907) 346-3323 (907) 346-3323
Notary Acknowledgement
9
Notary Acknowledgement
for
subscribed and
\0..........�4L %-
( op
��7r
ec:NOTARY16E
Y :. PUBLIC.1
FOUND SPRUCE STUMP
- o
- NOTHING SE(
cl
_
BY BEARING/BEARING
1
/iEW' ICIARY
INTERSECTION
1
Lot I
Lot 20A-2 1
Signature
HAMPTON MLS
PLAT
t3
SUBDIVISION
NE CORNER DETAIL
Scafe: I' • 10'
24
TAX CERTIFICATION
OF�% All real property taxes levied by the Municipality of Anchorage
A (!�� on the area shown on this plat have been paid in full, and if
Q : approval is sought between January t and the tax due date, there
is on deposit with the chief financial officer an amount sufficient
to pay estimated real property tax for the current year.
•.XENNE a.
A t.ANO,horized Official Date
V
LS -5202
ACCEPTANCE OF DEDICATION
CERTIFICATE OF OWNERSHIP AND DEDICATION
I (we), hereby certify that I (we) hold the herein specified property interest
In the property described hereon. I (we) hereby dedicate to the Municipality
of Anchorage all areas depicted for use as public utility easements, streets,
alleys, thoroughfares, parks, end other public areas shown hereon, a slope
reservation easement sufficient to contain cut and fill slopes of 1.5 feet
horizontal for each 1 foot vertical (1.5 to 1) of cut or fill for the purpose
of providing and maintaining lateral support of the eonstruMod streets.
Thera to rocervod by the grantors, their hairs, successors and assigns, the
right to use such areas at any time upon providing and maintaining other
adequate lateral support, as approved by the Municipality.
I (we), hereby agree to this plat, and to any restrictions or covenant
appearing hereon and any such restriction or eaveng t hall be binding and
enforceable against present and succeasi",,owners//,f subd!ded prop�rfy.
MICHAEL G SSH'ARROCK DANA L. SHARROCK
10001 HILLSIDE DRIVE 10001 HILLSIDE DRIVE
ANCHORAGE, ALASKA 99516 ANCHORAGE, ALASKA 99516
(907) 346-3323 (907) 346-3323
Notary Acknowledgement
9
Notary Acknowledgement
for
subscribed and
\0..........�4L %-
l:
sworn to beforeme this _{� day of l+=r• ,, 20
��7r
ec:NOTARY16E
Y :. PUBLIC.1
-Ndt//dry P#I116-for the Stafe of Alaska 6(y Commission Expires
RIND
_
Notary Public for the'Stota•of Alaska
FAY Commission Ex. 11
/iEW' ICIARY
THiS
1
Signature
Title
PLAT
t3
Ryan' Investments LLC~
24
1713 Momingt(de Court
Anchorage, Alaska 99501
6
The Municipality of Anchorage hereby accepts for public uses and for public
purposes the real property dedicated an this plat including, but not limited
to the easements, rights-of-way, alleys, roadways, thoroughfares and parks
shown hereon.
Dated of Anchorage, Alaska this 70' day of Tj7- 2061
G V
•Attest:
MVctpal Clark „gym Mayor of Anchorage
I Vicinity Map Scale: 1" = 1 Mile I
9
Notary Acknowledgement
JQ`tiPSHAAri,y//o
Q @:
je:: '••oma;
I 12
__ NOTARY`.
for Subscribed andy
sworn to before me this ,, day of 20C,/,
os
'�`• T1iC
-Ndt//dry P#I116-for the Stafe of Alaska 6(y Commission Expires
RIND
_
I Vicinity Map Scale: 1" = 1 Mile I
LAKEWOOD HILLS, ADDN. #2
CONTAINING 3,368 Acres
A SUBDIVISION OF LOT 20A, LAKEWOOD HILLS #2
(Plat No. 71-314)
LOCATED WITHIN THE SW 1/4, SEC 13, T12N, R3W, S.M., ALASKA
Lang & Associates, inc.
Registered Land Surveyors
GRID: 2540 SCALE: 1" = 10
DRAWN: JCL SHEET 1 OF 1
CHECKED: KGL
00%- F3
Anchorage, Alaska 99515
(907) 522-6476
1907) 522-4625 Fax
0'
DATE: JUNE 2001
PROJECT #: 00-133
JOB FiLE: K00133FP/FQ.crd,
CASE #: S-10645
9
g 10
1 II
I 12
I
� AB061'r
RIND
_
I
THiS
1
16
15
PLAT
t3
24
6
UPPER DVALCY
OVAI.E!
RWa
FRDAt
1
T 12 N
21
22
23
24 z
c
LAKEWOOD HILLS, ADDN. #2
CONTAINING 3,368 Acres
A SUBDIVISION OF LOT 20A, LAKEWOOD HILLS #2
(Plat No. 71-314)
LOCATED WITHIN THE SW 1/4, SEC 13, T12N, R3W, S.M., ALASKA
Lang & Associates, inc.
Registered Land Surveyors
GRID: 2540 SCALE: 1" = 10
DRAWN: JCL SHEET 1 OF 1
CHECKED: KGL
00%- F3
Anchorage, Alaska 99515
(907) 522-6476
1907) 522-4625 Fax
0'
DATE: JUNE 2001
PROJECT #: 00-133
JOB FiLE: K00133FP/FQ.crd,
CASE #: S-10645
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
tw
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR -A SINGLE FAMILY DWELLING -
Parcel I.D.
WELLING'Parcell.D. 015-134-20 HAA# 1-1 OI Ox -r _
1. GENERAL INFORMATION Expiration Date: 9 - - o0 /
Complete legal description' LAKEWOOD HILLS SUBDIVISION #2; LOT 20A
Location (site address or directions) 10001 HILLSIDE DRIVE, ANCHORAGE, AK 99516
Current Property owner(s) MIKE SHARROCK Day phone 346-4442
Mailing address 10001 HILLSIDE DRIVE, ANCHORAGE, AK 99516
Lending agencyDay phone
Mailing address'
Real Estate Agent Day phone
Mailing address
Unless otherwise requested, HAA will be held by DSD /or pickup.
2. NUMBER OF BEDROOMS: 6
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water sample results less than 30 days old. (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, l verify that my
Investigation, based on procedures outlined In the Health AuthorityApproval 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 sinicture Indicated herein. I further verify that based onthe
Information obtained from the Munldpality ofAnchorage files and from my Investigation inspection,the
on-slte water supply and%r wastewater disposal system is(are) in compllance with all applicable Municipal
and State codes; ordlnanoes,'and regu/ations in effect at tie time of Installation.. .
Name'of Finn; ALASKA, WATER '& :WASTEWATER CONSULTANTS, 'INC. phone .337-6179.
AddrassN 6901 DEBARR ROAD,:SURE 26 s ANCHORAGE, AK 99504
Engineer's Printed Name : JEFFREY. A. GARNESS, P.E. Date D1,
Engineers Comments:oo�o
!non
cducting this evaluation, AWKV, Inc. attempted to provide a thorough, - `�, QF 0 44
conscientious engineering anaWs of the system in accordance with ADEC and MOA
DSD Guidelines 6 Regulations. :T he reported results desatbed the performance of the
system under the oondNons encountered at the time of the test and separatfon D e
distances measured to readily Iden tifabis fee tures. The opera tonal life of all wefts and Q
septic systems depend on the local soils condition, groundwaterlevals that may DD
fluctuate during the year, and the Crater usage of the famlybeing served by the system. V"' : D
These conditions are outside the iiontrol ogre evaluator of the System. Satisfactory test OQ e f e _ ass;
results do not guarantee future system, ayg dQ of CE -7953 : ep
g performance of the tem, nor do N u varitee that u SFO
there are no hidden detects or encroachments. AWWC, Ina can thoreforenot provide . • ......
anywarranyorfuture estimate ofhowlongMesystem willowntinuetomeetthe X00°Profess°�o`�
operational requirements of the ADEC or MOA DSD. The content orthis report is for
the sole benefit of the ownerfisted above. Any reliance upon or use of this report by any
other person or paryIs riot authorlred, nor wffl R confer any legal tight whatsoever.
5. DSD SIGNATUREtliNl�tttffff/�i.-
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
• ON-SITE
WATER AND
WASTEWATER :
PROGRAM
By: 449� 4!)' /a"�r Original Certificate Date: 6-1-01
Vtw.l2=)
Municipality of Anchorage
• �' Development Services Department
Building Safety DMsion
Onsite Water 8 Wastewater Program
4700 South Bregaw SL
P.O. Box 196650 kichorage, AK 9951944
wwwxLarichorags.ak.us
(907)943-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: LAKEWOOD HILLS SUBDIVISION N2: LOT 20A Parcel ID: 015-134-20
A. WELL DATA
Well type PATE UA. B, or C provide PWSIDX N A
Date completed 8/13/99 Senitaryseal (Y/N) YES
Total depth 400 R Cased to 282 fL
FROM WELL LOG
Date of test 8/13/99
Static water level 250 1L
Wen production 2 — 3 g.p.m.
WATER SAMPLE RESULTS:
Conform 0 colonlesl100 ml. Nitrate 3.74mgJL.
Well Lop (Y/N) YES
Wires properly protected (YM) YES
Casing height (above ground) 18+ in.
AT INSPECTION
NEW
fl
g.p.m.
Other bacteria _0.00lonlesM00 ml.
Date of sample: P-5-18"01 Collected by: AWWC. INC.
B. SEPTICIHOL.DING TANK DATA
Tank Type/Matertal STEEL Date Umstelled 9/29/99
Tank size 2000 get. Number of Compartments 2 Cteariouts (Y/N) YES
Foundation deanout (Y/N)OYES Depreaslon aver tank (Y/N) NO High water alarm (Y/N) N/A
Data of pumping 4/17/2001 Pumper ISAAC'S
Date installed 9/29/99 Sop reting .p d fe/bdml) O_8 System type TRENCH
Length
65 R Width 2.5 R Gravel below pipe 9.2 fL
Total depth r � R Eft. absorption area 1196 M Monitoring Vibe `ES Depression over Held N0
Date of adequacy test NEW DRAINFlELD Results (Pass/Fall) For 6 bedrooms
781apsed
depth in absorytion field before teat_ UL Water ad
-Wow depth _in.
Time: uid depth _ Im. Absorption rate m 9.pd.
Any re)uvenation treatment (past 12 mo.) (YM d, type) NONE KNOWN If yes. give data —
D. UFT STATION
Date installed Size in gallons
'Pump on' level at_ in.
E. SEPARATION DISTANCES
High water alarm level at
Cycles Meets alar & circuit requiremerb?_
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanMIft station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
On adjacent lots 100'+
On adjacent kft 100'+
Public sewer manhole/deanout N/A
Sewer /septic service One 25'+ Holding tank N/A
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property One 5'+ Absorption field 5'+
Water main N/A Water service One 10'+ Surface water 100'+
Wells on adjacent Tots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property One 100+ Building foundation 10'+ Water main_ N/A
Water service One 100+ Surface water 100'+ Driveway, parldngNehlde storage 5'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION g,;re Ur
I certlly that I hem determined through field inspection and * ' X
review of MurUdpat records that the above systems are In ........ . . ............
conformance with MQA HAAguidellnes In effect on this date.
e A. Gameaa'
Engineer's Printed a JEFFREY A. GARNESS 7953
• �aF
Data O�•,�dp......... •.�o
HAA Fee S -IL _00
Date of Payment -5
Receipt Number a a�
(Rev.12=)
Waiver Fee $
Date of Payment
Receipt Number
1 •moi mol
O f� TONYKNOWLES, GOVERNOR
00
0
0
0
0
p
00
DEPT. OF ENVIRONMENTAL CONSERVATION C . D
DIVISION OF ENVIRONMENTAL HEALTH
�p
DRINKING WATER and WASTEWATER PROGRAM T. I 1---e* (907) 269-7521
555 CORDOVA STREET
ANCHORAGE, AK 99501
http://www.state.ak.us/dec/home/htm
e el,
Fax: (907) 269-7650
February 26, 1999 RECEIVED
MAR 1 1999
Mr. Jeffrey A. Garness Municipality of Anchorage
Alaska Water &Wastewater Consultants, Inc. Dept. Health & Human Services
7320 East Chester Heights Circle
Anchorage, Alaska 99504
Subject: Lot 20A, LakewooSource e Well,Hills Subdivision
ADECProject umberr4Alaska;
Water Systemstem
429, Construction Approval.
Dear Mr. Garness:
This letter is in response to your submittal received in this office on February 19, 1999
requesting construction approval for a new Class C Public Water System source well to serve a
six bedroom, multi -family dwelling on the above -referenced property.
From the submitted information, it appears that the location of the well meets the concerns of this
Department regarding separation distances outlined under State Drinking Water Regulations (18
AAC 80.030). Therefore, the Department is granting construction approval of the Class C Public
Water System source well in accordance with 18 AAC 80, subject to the following requirements.
1. Well construction shall be in accordance with AWWA Standards A100 and meet the
minimum construction standards outlined under State Drinking Water Regulations (18 AAC
80.015).
2. Separation distances between the proposed well location and the property located
immediately north (S 'h, SW 1/4, NW 1/4, Section 13, T12N, R3W) shall be physically verified
prior to well construction.
3. Decommissioning of the existing private well shall be in accordance with 18 AAC 80.015(d).
A Construction and Operation Certificate constituting this approval is enclosed.
This approval does not imply the granting of additional authorizations, nor obligate any federa6
state, or local regulatory body to grant required authorizations.
2 February 26, 1999
Mr. Jeffrey A. Gamess, P.E.
Thank you for your cooperation with this Department. If you have any questions, please contact
me.
Sincerely,
Steven A. Pettis
Env. Eng. Asst. II
SP/cf
cc: Jim Cross, P.E., MOA/DHHS, w/o end
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
FOR
PUBLIC WATER SYSTEMS
/SDG --c- Prsj.cf tt,/2f
A. APPROVAL TO CONSTRUCT
Plans for the construction or modification of C 5 S C
�w l cJc4-t' e � Sy 6-E-�.
# y Lo f o A public water system located in
50L w t I l, Lakewood lf-, fI s
—
Alaska, submitted in accordance with 18 AAC 80.100
�e, have been reviewed and are
by /Mask < kAJ 4 r a,"dh/
approved.
0 conditionally approved (see attached conditions).
TITLE DATE
BY
If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must
be submitted fotreview and approval before construction.
B. APPROVED CHANGE ORDERS
Date:
Change (contract order number or descriptive reference):
Approved by:
C. APPROVAL TO OPERATE
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before this system is made available
for use.
public water system was completed
The construction' of the
on (date) The system is hereby granted interim approval to operate for 90 days following the completion date.
DATE
TITLE
BY
As-built/record drawings, submitted to the Department, or an inspection by the Department, has confirmed that the domestic
wastewater disposal system was constructed in substantial conformance with the approved plans. The system is hereby granted
final approval to`operate.
DATE
TITLE
BY
Distribution: !. Retain original for project file
2. Make copies for distribution
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On -Site Sewer/Well Permit Application n i 2) . —� �ij — An
NOTE: Application must be filled out completely. SI LE FAMILY DWELLING Parcel Identification Number
ALa Cl CN
Property Owner Name P-4 �(- Day Phone
Mailing Address
Legal Description
Zip Code C�q_2__�kL1
Lot Size n afollowing:
Inspec ns wil1con j by: Number of Bedrooms: Approved Engineering FirmMunicipality (permit fee in licec � to
Does your house contain anyt Tub, Swimming Pool, Therapy Pool, Jac ez _-'k �>
or Water Softener Unit? If yes, which one?r t ny Q
uLA
This application is for: Sewer Only Sewer and Well Sewer"Upgrade,_ Welll
I certify that the above information is correct. I further certify that this application is being ma f inCg:1 F i19 R lin
and in accordance with applicable Municipal codes. \ ^\cam v_r, `
L\ 1)n17
Properly
Fees: 3 2 h r C)Z) Receipt # f��/ (�� �'�' Permit #
72-012 (Rev. 10/86)
Municipality of Anchorage
e DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Services Division
Telephone: 343-4744 a
ON-SITE SERVICES FEE DOCUMENTATION
Date Paid: 7-1
Name of Payer: (Name An Ch(
Mailing Address: (Off of
Legal Description(s):
Type of Payment: (Indicate Amount Paid)
feafth Authority:
i Excavator Permit:
Sewer & Well Permit: Engineer Permit: _
Well Permit: Pumper Permit: _
Sewer Permit- - 2 C2J Well Driller Permit:
Copy Request:
72-034 (Rev. 10/87)
— Tank Manufacturer:
(Waste Treatment)
DISTRIRI Mint&
Permit Number:
OS -01111
#: holoi-�
WAIVERS: 1' �4 17i s 1 y� c L_(Lot Line: #\T�\_
��Well to Tank:dc<j c
�L
Well to Field lc� neo cam'
n'
Field to Surface Water
Tank to Surface Wat Q�
- o— � °s``y`a�
SENTEC Inc.
7801 E. 36th Ave.
Suite A
Anchorage Alaska 99504
Phone (907) 333 6881
Fax (907) 333 10§5
July 16, 1995
70�-
_ z0
Department of Health and Human Services
Division of Environmental Services
rT1
v
.On -Site Services Section
�
m o
P.O. Box 196650
Anchorage, AK 99519-6650
it's
v, N o
®
y
RE: Sharrock Septic Upgrade Approval L20A Lakewood Hills No.2 Subd .
0
z
Sir:
Please find the attached application an upgraded drain -field system for the above
property.
DESIGN NARRATIVE
The owners of this lot report that the existing drain field is not absorbing the sewage of
the family. The proposed upgrade field will be located parallel to the existing field and
tie into the existing tank. A small addition is planned pisiFfed for the house, so an
alternate field location is shown and the design will allow for Four bedrooms. Lots in
this subdivision are three to five acres in size. All wells and septic systems in the area
are greater than 200 ft from the proposed field. The proposed improvements will have
no negative affects on surrounding wells or septic systems. There will be no affect to
drainage in the area, all water bodies and streams are greater than 200 ft away. There
is adequate space on the lot to allow for an alternate drain field.
If you have any questions, please give me a call.
Very truly yours, {
Gr M.
s MunWpallfy of Anchorwio -
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 88502-OSW
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: fn J kG 5 m A R no c_K DATE
.LAI<( wpo10
LEGAL OESCRIPTION: U T' 7,o A. 14 tLLS >`/ o. ?_ Township. Range, Seatlon:
D£PT14)O �. A,T,. SLOPE, SITE PLAN
f p r wTl ITTf 7 ITTr-�
2-
3 3
4-
7 7
s N a
LI
10-
11
0 11 i
tz �
14
15
18
17
18
is
20
COMMENTS
!3 rtcwu 5 +.,T w/ 1 A'qn
13rzo�N Sl�i
GTt Av 6
WAS GROUND WATER
ENCOUNTERED? �!
S
IF YES. AT WHAT L
D£P��ZTH? �-A O
P
Mite
E
Depth to water r
✓ling? Na E Date:
PERCOLATION RATE (mmutM/lnch) PERC HOLE DIAMETER 6 .,
TEST RUN BETWEEN FT AND '4 FT
PERFORMED BY: (_� 01 g cj= M Rm T .V A f^ . I _ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE—' 6 /.T 3 0/ S
72-00a (Rev. 4/85)
07/17/95 16:40 TX/RX NO.0443 P.001 0
i
3
a
�■■��� .:
r�
®rte
PERCOLATION RATE (mmutM/lnch) PERC HOLE DIAMETER 6 .,
TEST RUN BETWEEN FT AND '4 FT
PERFORMED BY: (_� 01 g cj= M Rm T .V A f^ . I _ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE—' 6 /.T 3 0/ S
72-00a (Rev. 4/85)
07/17/95 16:40 TX/RX NO.0443 P.001 0
i
3
a
Tia � � ..,;�:`•:
a .. Muniafpatity of Anchorage
DEPARTMENT OF HEALTH & HUMAN'SERVICES
825 •'L" Street, Anchorage, Alaska 99502-0650
SOILS LOG —• PERCOLATION TEST"
PERFORMED FOR: M 5 pf? V C DATE
1,,, Ak- 4ad o ti
LEGAL DESCRIPTION: LOT �D Nb. Township, Range, Section:
DEPTH tDX & ` SLOPE SITE PLAN
L3R.,w�.1 Slyj
2
3
) -�
�.
4I
6
r
�~
G R Avr- L
7
'
�•
$
1 I
b
9
10
E1
12
b'
G�Db*iE<T
13
N�L.E j
14
15
16
17
18
19
20
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, ATWHAT
DEPTH?
MENEM ME IN
MEM■ MErMI
PERCOLATION RATE S6
(minutevincn) FERC HOLE DIAMETER
TEST RUN BETWEEN 3 FTANO —/FT
PERFORMED BY: C" G- i CERTIFY THAT THIS) TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: _ ' i n / '.) 5
_T
72.008 (Rev, 4i85) 41
07/17/95 16:40 TX/RX N0.0443 P.002 0
rermiT NO. rage OT
W.O. 93234
Municipality of Anchorage
Date 7/12/95
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Bog 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 20A Lakewood Hills No.2 SUED. PID No.
TBM - ASSUMED ELEV-100.0' -
SOUTHEAST LOT CORNER MONUMENT
CONNECT TO EXISTING PIPE ELEV - -90.2 \ 1
ABANDON FISTING DRAIN FIELD IN P�IACE/ 1
C ALTERNATE FIELD
\ O
CLEAN T \ 4
N
/ 1
OU 4- SOLID PVC (TYP) \ 1
G SEE 11
PROPOSED DE
SYSTEM SF) 413dr XIS OODO 0 1.2 App. rat. = 500 Iron
i ITFST LE
\\ \ 4' PE\ PVC (TW) \ 1
DUSTING FIELD \ \ LT 20A OOD HII1S N0.2 SU80. 'Al_ 1 " = 20'\
o \\
U-)
OFA
(q��1
o O TEST .. '
rn \Ar
0 00 Q� . •••
00
\\
O-T)
f
A GREGOR P �•y /
\••a CE 7892 �.�ll� r MONITOR TU E 4���'r••••••••••• \
\ \ Professt ♦♦
ATE 141jL%"*
Permit No. Pageof
W.O. 95234
Municipality of Anchorage
Date 7-12-95
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Boz 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 20A Lakewood Hills No.2 SUBD. PID No.
GEOTEXTILE FABRIC. SEE NOTE 13
3'-6" MIN. COVER (3'-0" MIN.
RESTOR EXIST. GRADE AFTER CONSTRUCTION AFTER SETTLMENT) SEE NOTE 15
4" CLEANOUT
4' MONITOR TUBE1
� �X/SnNG
\ \ SFp77C
k
N
4.5'
-SEWER ROCK PER MUNICIPAL
SPECS. SEE NOTE 10
2' MIN TRENCH WIDTH
4" PERF_ PVC (TYP)
INVERT = 84.5'
A TYPICAL SECTION
N.T.S.
Permit 1'4'O. Page_ot
W.O. 95234
Municipality of Anchorage
Date 7-12-95
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744
On—Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 20A Lakewood Hills No.2 SUBD. PID No.
NOTES:^
1 ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATION
OF THE MUNICIPAL CODE AS CURRENTLY AMENDED.
2 SITE TOPOGRAPHIC SURVEY CONDUCTED ON 6-6-95. EXISTING STRUCTURES SHOWN ON SITE PLAN
ALL LOTS IN SUBDIVISION SERVED BY INDIVIDUAL WELLS
3 ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION
INTO THE SYSTEM.
4 CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES, PROPERTY LINES, EXISTING WELLS, WATER WAYS,
SURFACE AND SUBSURFACE DRAINAGE FACILITIES, LAKES, PONDS, AND OTHER FACILITIES REQUIRING
SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM. NOTIFY THE ENGINEER OF ANY OBSERVED
CONFLICTS PRIOR TO CONSTRUCTION.
5 NOTIFY THE ENGINEER 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE
INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE SUBGRADE, PRIOR TO PLACING
SAND FILETER. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF GRAVEL, DISTRIBUTION
PIPING, STANDPIPES, TANK, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD INSPECTION SHALL BE
AFTER THE WORK IS COMPLETED.
6 CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED -LINED, AS -BUILT DRAWINGS SHOWING ALL DATA
AS SPECIFIED IN SEC. 15.65.F.2, 3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN TEN DAYS OF
THE FINAL INSPECTION. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT. THESE
AS-BUILTS SHALL BE USED TO DOUBLE-CHECK THE ENGINEER'S INFORMATION PRIOR TO SUBMITTAL TO DHHS.
7 STAKE ALIGNMENT OF SYSTEM WITH MARKERS SHOWING THE PROTECTIVE DISTANCES FROM WELLS AND
OTHER BODIES OF WATER PRIOR TO BEGINNING INSTALLATION.
g ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE
ENGINEER.
9 EXCAVATE THE ABSORPTION FIELD. BOTTOM OF EXCAVATION SHALL BE FREE OF ORGANICS AND SCARIFIED.
RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF BED BOTTOM. CONSTRUCTION EQUIPMENT SHALL
NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF
THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL.
10 PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE ROCK WITH NATIVE MATERIALS OR
SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO f 1" PRIOR TO INSTALLING THE PERFORATED PIPE.
11 ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER -APPROVED EQUAL.
12 GEOTEXTILE SHALL BE MIRAFI 1405 OR ENGINEER -APPROVED EQUAL. LAP ALL JOINTS 2' MIN.
13 MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS.
14 SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MIN. SLOPE, AND 3:1 MAX SLOPE, AND IN SUCH A MANNER THAT
PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN
SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS.
v,sQ ZZ) r,l/vim
S�i� f� X / /7 a 7
No. 7678
Sold To C
La eu"3(�e�& AWS
Shipped To / g�
Address__
RECEIVED
JUN 51995
IViunic.paitty vi Hnchoragq
Dept. Health & Human Services
DATE
SALESMAN
TERMS
F. O. B.
VIA
�4/
Y A Z E' f /
00
ze
LO Y w
I
I
IF
O—
i
2L r
i
741729 ® Afton