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LAKE RIDGE TERRACE BLK 2 LT 22
Municipality of Anchorage .,.. ~, Development Services Department ~'-: = .,o Building Safety Division =~"'I~-*~ ~ · On-Site Water & Wastewater Program. 4700 South Bragaw St. ~--~ P.O. Box 196650 A~chorage. AK 99519-6650-..., ~" www.ci.anchorage.ak.us (907) 343-7904 Page 1 of On-Site Wast°water Disposal System and/or Well Inspection Report Permit Number:. SW020100 PID Number:. O51-315-05 JOHN RUSSELL Wastewater System: r-i New · Upgrade 14727 WEST LAKE RIDGE DRIVE ' EAGLE RIVER. AK 99577 ABSORPTION FIELD No. of Bedroom.: Ph°n':(907) 696-5575 3 i r-i Deep Trench · Shollo. Trench r'l Bed r'l Mound · Other* LEGAL DESCRIPTION ~' "'~ 5.0 ~/~ ~ 6.5 (MAX) 2 22 LAKERIDGE TERRACE 2.06 (MAX) r~ 4.11 - - - SEE DWG r~ 25+ WELLI D New D Upgrade 5 n. I - r~ RPC EXCAVATING 10-51/2002 ,~ ,~ TANK SEPARATION DISTANCES eBepu~ ~ "old~g rlS.T.F-P. · Oth.r~ To Bept~CTank Ab~'~°?dt;°n St~uonUft Hold[ngTank~,~,/~ ANCHORAGE TANK 1500 we~t I00'+ 100'+ - - 25'+ FIBERGLASS 2 sM,ac, wot., ~oo'. ~oo'. - - - LIFT STATION · '1'+ -- s~ ~ ~ I Lot Un° -- -- 1500,ANCHORAGE TANK/ORENCO SYSTEMS FoundoUon 5'+ 10'+ -- -- -- TI~VlER TIMER 46 Curtain Or~In NCiNE KNOW uODD_ 30 1/2HP M.O.A. Remarks: *THIS IS AN ADVANTEX TREATMENT UNIT BENCH MARK · 'WANER ~qWR020100 TOP OF HOSE BIB THE OLD SEPTIC TANK AND CRIBS WERE COIdPL/TELY TOP OF' blH UD = 102.18 ABANDONED PER UNIFORM PLUMBING CODE. 100.00 r~ inspections performed by: 'KWWC, INC. Dates: ,st 5/10/2002 Development Services Department Approval ~?~....[ ........ ..~.~ R&viewed and approved by: ~t~'~'?'/_J. /?,-~ Dote:'7. /~-~2~ \ A B ST1 52.38 66.06 POD 56.58 69.52 IdH 62.42 74.52 C01 42.27 49.24 C02 41.99 51.79 IdT1 58.92 55.97 C05 42.75 61.90 I u.o.~, rECOr~ No UT1 58.92 55.97 / / /// I pIPES ASOV[ GR*O[ C05 42.73 61.90 .... ~ ~ / / ~ ~v ~. ~,, '~ ~SI~ ~WI'ER & WASTEWATER c.J.o. ."' ' '" .~ ~0 ~ CONSULTANTS, INC. ~ ~.....~ JOHN RUSSELL (907) 696-5575 2 OF 5 : ~" ~OT ~. e~oc~ ~; ~ moo~ ~,,,c~ suemws~o. '~:-97~-I ...... ~ AS-BUILT DRAWING Or SEPTIC SYSTEM UPGRADE ~ ~'~: AS- BUILT D RAWIN G SW020100 051-315-05 TOP OF ADVA~',~E:X POD ~P OF BL~ DISP~ 2'+ ~ ~ ~IL ~ P~ ~ ~ ~D INSU~ON ~OUND P~lM~ OF ~O ~ T~ I O~ ~NOWA~R ~ ~ 11.5 ~' ~ ~ ~ ~ ~E 93.92 ~.) ~ ~R~K OR 7/1/2002 C.J.G. .. ~SI~[ WATER & WASTE~'ATER ~ JOHN RUSSELL (907) 696-3375 3 OF 3 LOT 22, BLOCK 2; ~KE RIDGB TERRACB SUBDIVISION ~E Or WORK: ~A~rofess~o~ PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: May 09, 2002 Expiration Date: May 09, 2003 Permit Number: SW020100 Legal Description: LAKE RIDGE TERRACE BLK 2 LT 22 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: John Russell Owner Address: 14727 W LAKE RIDGE DRIVE EAGLE RIVER, AK 99577-9239 Parcel ID: 051-315-05 Site Address: 014727 LAKE RIDGE DR W Lot Size: 25800 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day, B. Covered, sealed, and heated to prevent freezing. 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 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 051-315-05 Permit Number .~'I,~OZ OIOO Property owner(s) ~OHN RUSSELL Day phone §96-3375 Mailing address (1) 14727 WEST LAKE RIDGE DRIVE ', EAGLE RIVER. AK Mailing address (2) Zip Code 9)577 Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size ~ ~"~;OO Acres~ THIS APPLICATION IS FOR: Sewer Only ~ Sewer and Well Sewer Upgrade · LOT 22. BLOCK 2: LAKE RIDGE TERRACE SUBDIVISION Number of Bedrooms Well Only Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Jacuzzi Water Softening Unit I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER &: WASTEWATER CONSULTANTS~ INC. Permit Fees: Date of Payment: Receipt Number:, Waiver Fees: ;~ /~'~'-*~- Date of Payment: "~-~.~ - O,.~ Receipt Number:, ALASICA WATER & WASTEWATER CONSULTANTS, INC. April 15, 2002 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Reft Septic System Upgrade and Waiver Request for Lot 22, Block 2; Lake Ridge Terrace S/D. AD VANTEX'r'~z TREATMENT SYSTEM To whom it may concern: 1. GENERAL: The existing three (3) bedroom house is served by a private well and septic system. The existing septic system consists of a 1000 gallon septic tank and a seepage pit type drainfield. The septic system is in a state of failure and must be upgraded. Due to the setbacks from the existing septic system, the house foundation, the protective well radii, and a subsurface drain that runs along the west and noah lot lines (per MOA records) there is very limited area for a new septic system. In order to reduce the "footprint" of the drainfield, we are proposing to utilize an Advantex treatment system. A test hole was excavated near the southwest comer of the house. We are proposing to install the new drainfield within the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring, and the pemolation test results. 3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment System that will allow the use ora small drainfield in the area around the 30 foot radius of the test hole. A percolation test was performed in test hole #1 at a depth of 5.0 to 5.5 feet and · determined to be 6.0 minute/inch. Given the performance of the Advantex systems currently installed, it is anticipated that the system will be rated as Class III. However, given the fact that this has yet to be established, we are.proposing to utilize a Class II system application rate. For a percolation rate of 6.0 minutes per inch, an application rate of 3.0 GPD/FIa would apply. In addition, it is anticipated that a 2 foot separation distance to groundwater will ultimately be approved for the Advantex system; however, we will provide a 4 foot separation distance with this design. 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 ~ Fax: (907)338-3246 4. TRENCIt DESIGN: a. Percolation Rate: 6.0 minutes/inch b. Allowable Application Rate: (5.0 gpd/ft2 for a Class III system) 3.0 gallons/day/ft2 rate assumed for this design. c. Number of Bedrooms: 3 d. Design Flow: 450.gallons per day e. Minimum Absorption Area: 150 ft: f. Total Depth: 6.5 feet (max.) g. Effective Depth: 4.0 feet h. Width: 5 feet i. Reduction Factor: 0.50 ~ Minimum Length: 20 feet long · Effective absorption area: 200 ft: 5. ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 6. SURFACE WATER: The east property line is border by Lower Fire Lake. The proposed septic system will be located over 100 feet from the existing lake edge. 7. TOPOGRAPHY: The topography in the area for the septic system is a generally flat. 8. LOT LINE WAIVER REQUEST: We request that your department issue a I foot lot line waiver from the south property line to the proposed drain field. We are unaware of any adverse effects on the adjacent property with the granting of this xvaiver. 9. CLOSING: I am open to any suggestions from your department that would be an improvement to the proposed system. I am unaware ofany negative impacts that this installation would impose on/6djacent wells, or septic systems. If you have any questions, please call us at 337-6179. /~/ Je[/re~l^ ,arness, P.E., M.S. Pr~si~nl NOTE: Attached is a site plan drawing, a design drmving, an Advantex detail, a trench detail, a soil logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 ~ Fax: (907)338-3246 / / /,' ~ LOT 18o BLOCK 2 . I / /l ~ ~:,;,, ,,,,,.,,,., /, ~,,~,,,, ,~,,,,,,?;, ff ~ :;2::,..,,,.,,,,,, / ~'~ ~G&:., ,,,,,. ~,'/,' ,',',' 5',','-5'/ ',¢,?',¢,?,, 75',,,',,/ I ,/ ~ ~/'././//// / ///////////, ; / ~Y~','~,~,'/; , , , _, , , ; ~. ~ ~'.X.,','/~,~', ,','-' ,','; ' I /~, I / ~ / /.//// / / // / / // ~ ~ ~ ~i '/~/ / /-/-/-/ I I ] ~ =: / ~ / ////// / //_/ / I ~x ~ ?/~,',',',~,;, ,?;,,,?,'. .... ~, ~NO ~ rip / / / /-/ / // / // / / / , ~ -Z ~,~ ~ . ~,,,,/,,,,, / ,',,_,,/, ~'.~ /I ..---~.3 s,.,',,.,',,,,,,., .,,,,,,,,.,?. '!'~.~~ i %,2:~,', .27,,,,;,;,: I ~ ,%~, , .~',',',~/, ,'_,',',','; I~._~ ~ ,/~/b///./.'~,-// / /////. /,; ~ ~,,.,,~ ~. ~, o~,~,,, ,-,.~,,, _,,, ,,,,, I ~[ RISC ~E S/D I / /~/ /,~/: ~ . ,--: ,,-,,,.,,,,.,.,,-,_,_,,. t '//////_//////Q /- ~ I I ,-5',',-,,,',','.-.,.'.-.', ~-' ~w. ~: ~..-c"'~. ~'~ A~SI~ ~FER & ~STE~I'ER ~ LOT 22. BLOCK 2; ~K[ RIDGE TERRACE SUBDIVISION ~._~'..AJ ...."~.~ SITE P~N FOR SEPTIC SYSTEM UPGRADE AND WAIVER REQUEST I ~.1~'"~O ~= 100 W~LL RADIUS ~ ~ ~ LOT 21, BLOCK 2 : I _~ ~PROXI~TE LOCATION O~ CURTNN J ~ / HOMeOWNeR. PER HOMEOWNER, A ~, ~ .... ~. / ~cx.sz,Nc scPnC scEP<E P.s ~' ,~-~ L_----~I / % / (~PROXm~TE L~TmON) . ~o~. / ~.. ~LL RAmUS REFERE~US FO~EIC~ORiNO I THE ~KE [OCR F~GCED BY A REGISTERED ~ND SU~EYOR PRIOR TO ANY I ! CONTRUCTION. THE CONTRACTOR SHOULD ALSO NOTE THAT THERE ARE UTILITIES j ~N T.[ ~ Or THE S[.T~C U~C~D[. ~T ~S THC CONT~C~O.S R[SPONS~B~U~ TO HAVE ALL UTILITIES LOCATED AND COORDINATE WITH THE UTILI~ COMPANIES ~:IF UTILITIES LIN[/$ WILL NERO TO BE RELOCATED. 0~WN BY: tg5 CONSULTANTS, INC. JOHN RUSSELL (907) 696-5475 2 OF 4 ~o~ ~. ~oc~ == ~ .,~o~ ~,,~c~ su~,v,s,o, ~v_~,~_~ DESIGN OF SEPTIC SYSTEM UPGRADE AND WAIVER REQUEST AdvanTex Treatment System ~ P.~ ~ ~E IN~ ~R ~E S~C T~ & 4' AX Series Mode la ~ ~ ~ ~.~ o. ~ ,,~ ~ ~.~ . Two (2) 34x48 Pods ~' ~OU T~K B'- ti INLET ~ ~ , , ~ ~E ~-10 PODS S~L BE PLUMBED~mo (2) ~-~o SO ~T TH~ ~ RL~S ~CH BE ISO~TED. PASSI~ AIR ~T~ 2' INSU~ON ' ~ ~M 1~1~ SCREENED ~.. ~Xf~ ~J VAULT 4/15/2002 . CONSULTANTS, INC. ~.~.~. PR~ FOR: PHONE NUMBS: JOHN RUSSELL (907) 696-5575 LOT 22, BLOCK 21 ~KE RIDGE TERRACE SUBDIVISION ~ OF WOR~ Pr ~ o~~ DETAIL DRAWING OF ADVANTEX TREMENT UNIT · ~f~OU A~V.N~X UNrT I I I' 20 FEEt LONe INSTN. J.fiNALCt.EANOUTS---~GRADE ~ ~_INSTN..L MONn'ORINO TUBE: CONSULTANTS, INC. JOHN RUSSELL (907) 696-5575 4 OF' 4 . . LOT 22, BLOCK 2; LAKE RIDGE TERRACE SUBDIVISION ~ £ ['795'x '"" DETAIL DRAWING OF' TRENCH ALASI(A '~rATER & '~VAS TEWA'I'ER . LEG& DESCRI~ON: kO~ 22, BLOCK 2; ~E RIDGE ~R~CE SUBOMSI~~ PERFORMED FOR: JOHN RUSSE~ DA~: 4/5/2002 ORGANICS ITEST HOLE #1I SOILS LOGGED BY: GM/SM SOIL CLASSIFICATIONS GP ML GM CL GC OL SW NH SP CH SM OH SC DEPTH TO GROUNDWATER DATE 12.5' 4/5/2002 11.5' 4/8/2002 11.5' 4/12/2002 DATE 4/8/2oo2 I IREADiNG CLOCK TIME 1 12:49 2 1:19 ,3 1:19 4 1:49 5 1:49 6 2:19 PERCOLATION RATE 6.0 (MIN./INCH) TEST RUN BETWEEN 5.0 FT.~JqD A FOU~HOUR PRESOAK WAS PERFORMED: JODY MAUS NET TINE (MINUTES) WATER LEVEL READING NET DROP (INCHES) ,30 ,30 ,30 6" PERC. HOLE DIA. 5.5 FT. I YES I--INo CALEB CALL PERCOLATION TEST PERFORMED BY: 5 5# (INCHES) COMMENTS: PERFORMED BY ~W,W.C., INC. I, JEFFREY A. CARNESS, CERTIFY THAT THIS W/kS J~ERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL OUIDELINES IN EFFECT ON THIS DATE: ent By: Alaska Water and Wastewater Con; 907 338 3246; Apr-17-02 12:32; Page 1/2 Municipality of Anchorage Development Scrvice~ Department P.O. Box 196650 Anchorage. AK 99S 19.66~0 PROPERTY OWNER AGREEMENT FOR TIlE MAINTENANCE OF AN ON-SITE VVASTEWATER DISPOSAL SYSTEM ThN agreement, dated ~f / / O~/~ ~ ,is made between the Municipality of A~lchoragc Development Serviccs Dep'a.,:tmcm{'DSD) and the property owner, s) of: This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owner~ agree to the following: Submit to the Municipality of Anchorage, on an aanual basis, an inspection and operation statement front a regiatcrcd profc~sional engineer. This inspection aad operation statement shall verify that the engineer has inspected all effluent and a{r pumps, timers, and alarms, and that an)' deficiencies have been repaired and that the system is funclioning as designed. (Printed Name) (Printed Name} Municipality of Anchorage George P. Wuerch, Mayor Building S,'xfc~' Dirision I50. Box 19C_ff~0 · 4700 S. Bragaw Street ~.nchoragc, Alaslm .09519-66.50 * (907) 1~-~3-8301 http://xx'ww.cl.mlchoragc.ak.us 5/9/2002 Jeff A. Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Lake Ridge Terrace Subdivision Block 2 Lot 22 Waiver Request #WR020012 Pamel ID #051-315-05 Construction Permit Number SW020100 Dear Mr. Gamess: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Civil Engineer On-Site Water & Wastewater Program Municipality of Anchorage Development Serviees Department Building Safer/Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 995 [9-66~0 www.ci.anchorage.ak.us (9o7) 34a-7904 Waiver Review Worksheet VVR~: WR020012 PID~: 0S1-315-05 HAft: Date Received: 04/22/02 Legal Description: Lake Rldoe Terrace Block 2 Lot 22 Engineec Ala~ka Water & Wastewater Consultants. Inc. 6901 DeBarr Rd. Suite 2B Anchorane. AK 99604 Applicant: John Russell Permit~: 5 {.~t~2 O/OO Waiver Requested: 1 foot from the south orooertv line to ~e Drooosgd dr~ll~ field. Criteda: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: ~ Waiver is not Granted: LlatConditionsorReasonsforabove: ,~' E £$,/~ I/I/EEI~ '$ /~"f',~'tlf:/) l Name of Reviewer Rec~: 18666 Amount: $150.00 Date Paid: 4/22/2002 ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~ June20,2002 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Waiver Request and Health Authority Approval for Lake Ridge Subdivision; Lot 22, Block 2, The existing 3 bedroom house is served by a private well and septic system. We request you grant a 82 feet separation distance waiver from the well on the referenced property to the septic tank on Lot 23, Block 2, Lakefidge Terrace S/D. The well that serves the subject property was drilled in 1969, and the septic system for Lot 23 was installed in 1983. The following items are justification for the waivers: There is a slight mound and heavy vegetation between the well on the subject property and the neighboring septic system. If the septic system was to overflow, it appears that the effluent would not travel toward the well head. The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. The other path of contamination is subsurface migration wastewater should the tank begin to leak. As can be seen on the attached well log, the aquifer is relatively shallow, with approximately 15 feet of silt, sand, and hardpan soils that have served to inhibit the migration of untreated wastewater into the aquifer. Recent water sample results indicated nitrate levels and coliform bacteria results to be satisfactory. Based upon the aforementioned facts, it appears that there is minimal risk associated with the 82 feet waiver requested. The well that serves the subject property was drilled in 1969, and the septic system that serves Lot 23, Block 2; Lakeridge Terrace S/D was installed in 1983. It is our understanding that the property owner of Lot 23, Block 2; Lakeridge Terrace S/D is responsible for the waiver fees. We also request that~y r department issue a Health Authority Approval /t~tvt~ .tions, please contact at 337-6179. Thank for US you your assistance. s P.E., M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com Municipality of Anchorage Development Services Department Building Safely Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WRY: WR02001~ PID~: 051-315-~ HA#: HA020299 Permit~: Date Received: 712/0:~ Legal Description: Lake Rldi~e Terrace Block 2 Lot ?~ Engineer:. p.. Alaska Water & Wastewater Consultants, Inc Applicant: John Russell Waiver Requested: 82 feet from the eublect well to the septic tank on nelohboHno lot 23 block 2 I. akn Rldue Tewac9 Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver ls Granted: Waiver ls not Granted: List Conditions or Reasons for above: Date: By: Name of Reviewer Rec~: Amount: Date Paid: 71t'II2002 Municipality ,of Anchorag¢ Building $~i.x' D~xus~on P.O. Box l(,X~l) * 4700 S. Bragaw Strcct Anchorage. Alaslu~ ~)519-~S,50 · (907) 34-3-~301 h t q~://www.ci.m~choragc.ak.us 7/15/2002 Jeffrey A. Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Lake Ridge Terrace Block 2 Lot 22 Waiver Request #WR020012 Parcel ID #051-315-05 Waiver Request For Water Well On The Subject Property to the Septic Tank On Lot 23 Dear Mr. Gamess: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 82.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Civil Engineer On-Site Water & Wastewater Program I I ~ 7 ~=.2~ 2 Gnn~o roT~ - ~, 7 .:.~ DALLY DRILLING LOG ;' ;' Avenue PENN JERSEY DRILLING CO. Anchorage, Alask~ 99502 ' FROM .............. l;'l'. TO ..... FT ........ FROM..~' .......... I~T. TO ........ Fr.__. g REATER ANCHORAGE AREA~iBOROU SSOO TUDOR:ROAD POUCH:6~650 ANCHORAGE. ALASKA 995021 :DEPARTMENT :OE ENVIRONMENTAL QUALIT-Y:{ December 9, 1971 Dr. John P. Rollins 2900 Providence Avenue Anchorage, Alaska 99502 Subject: On-Site Sewer Installation, Lot 22, Block 2, Lake Ridge Terrace Subdivision. Desr Dr. Rollins: On August 24, i971, you obtained a permit from this Department for the addition of a dra~nfield to your existing sewer system. Please advise this Department if the addition has been made or if you wish your permit kept valid in our files for 1972. Sincerely, C. Sue McK6chnie Environmental Control Officer Dear MaSs~m: A 4 inch preforated plastic pipe was placed at the 5½ ft. depth, running from th~: south west corner, nearly l~mallel to the road, across the lot, and down the north side towards the lake. A total of 250 feet of pipe was installed, backfilled with gravel. Hopefully this will drain off the surface water, preventing it f~om entering the septic tank and seepage pits. very truly yours, GRF ,]'ER ANCHORAGE AREA BOROIJ-' ' HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME / ' SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY MATERIAL INSIDE LENGTH / '~ ~r CO~P~RTMI~NTS ~ ~ INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS ~-~ OUTSIDE DIAMETER LINING MATERIAl NEAREST LOT LINE. OR WIDTH DISTANCE FROM WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH , DEPTH · BUILDING FOUNDATION TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE FOUNDATION DISTANCE BETWEEN LINES SQ. FT: LENGTH OF EACH LINE , NEAREST LOT LINE TRENCH WIDTH TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: /'g O T TYPE. LOT LINE ."~ ~ ~ C I... ~ j~ V.~ '7~ DISTANCE FROM WATER DEPTH. , BUILDING FOUNDATION. · SAMPLE NEAREST NEAREST SEPTIC SEEPAGE OTHER ., SEWER LINE. , TANK , SYSTEM , CESSPOOL , SOURCES DISTANCES: i DIAGRAM OF SYSTEM 'GREATEI.. NCHORAGE AREA bROUGH Case " HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMII' NAME OF APPLICANT '",,~,~?.~,/~'~"W~,.~ /¥J.-?) MAILING ADDRESS~46/.~'/~ RESIDENCE ADDRESS~ ~ ~ ~,-,.,-~ ~,'~ LOCATION OF INSTALLATION ~ TO SERVE THE FOLLOWING FACILITY ~ ~F_O~O~ FINANCED THROUGH TO BE I~STALLED BY ~ PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS 1~'/[ ~"~, , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED SEPTIC TANK SIZE 1~0© TYPE ~"'F~__~L_. SEE DISTANCES: Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. n^Tr' ,/<~/ .~0/'t') 'g'}' A PPI I P.A ~ Tg .gl G ~ ATI' R E/~'.~.~' /~- 'REATER ANCHORAGE AREA BOROUGH ~ " ' ,~ HEALTH DEPARTMENT CASE # 32? EAGLE STREET ANCHORAGE, ALASKA 99501 This Form Reports a: Sozls Log Depth Feet Soil ' ......... '~' ' '" ' Was Ground Kat~r E~.ountered?~ Location Sketch P9oposed !nstalT~}~o~-~ Seepage Pit / Drain Field Depth ~f/zl nlet rest Pe=fo=med 6139 1077 • • • Municipality of Anchor. r�►-i?�'" ' A��° -t - On-Site Water and Wastewater Progra (907) 343-7904 a A)l-Progra ! Y $ A t E T ti Certificate of On-Site Systems App of 6 8 L. Parcel I.D. 051-315-05 Expiration Date: O c-+ 301 .2013 1. GENERAL INFORMATION Complete legal description Lake Ridge Terrace Block 2 Lot 22 Location (site address) 14272 W. Lake Ridge Drive Eagle River, AK 99577 Current Property owner(s) David and Robin Bassett Day phone Mailing address 14727 W. Lake Ridge Drive Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: ati if / • pi, Date: '04/ COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ S Waiver Fee $ Date of Payment c7— e Co •'P Date of Payment Receipt Number 6 i1r�foL Receipt Number COSA# 0 . F33 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 Forge Engineering Phone (907) 522-7773 Address PO Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 7/13/2018 OF As�l j*:eco49 TH /\ ��� 6. DSD/SIGNATURE 074-4-Let j -1- - 1 ' System #1 Approved for 3 bedrooms Michael E.Anderson :L`/ - r�h�/�F �4381-E-Y • f System #2 Approved for bedrooms tr••. � Disapproved i>>\���"`��4 Conditional approval for bedrooms, with the following stipulations: 0*S� PNV 2 N.4 ts 51 A/Ing.NIT By: QP4„,fi Tim E-cf< 'Un J Original Certificate Date: Ji 30) .2o18 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other . . COSA blue Sheet f c 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: Lake Ridge Terrace, Block 2, Lot 22 Parcel ID: 051-315-05 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) N Date completed 1989* Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 115* ft. Cased to 30+* ft. Casing height (above ground) 12 in. FROM WELL LOG AT INSPECTION Date of test 7/5/2018 Static water level ft. 13 ft. Well production g.p.m. 5'0 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 6/20/2018 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advantex/Fiberglass Date installed 5/10-31/2002 Tank size 1 '500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 3/21/2018 Pumper Anchorage Tank Maintenance C. ABSORPTION FIELD DATA Date installed 7/27-28/16 Soil rating (g.p.d./ft2 or ft2/bdrm) 3 GPD/SF System type 5'Wide Trench Length 30 ft. Width 5 ft. Gravel below pipe •5 ft. Total depth 6.5-7 ft. Eff. absorption area 150 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7/5/2018 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 481 gal. New depth 0 in. Elapsed Time: 0_ min. Final fluid depth 0 in_ Absorption rate >= 450 g p d N Any rejuvenation treatment (past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed 5/10-31/02 Size in gallons 1 ,500 Manhole/Access (Y/N) Y "Pump on" level at Timer in. `'Pump off" level at Timer in. High water alarm level at 46 in. Datum Bottom of Tank Cycles tested Three Meets alarm& circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot '100' On adjacent lots '100' Absorption field on lot 85'** On adjacent lots '100' Public sewer main '75' Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank >75' Animal containment areas '50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line 'S Absorption field 'S >10' >100' Water main Water service li line >10' Surface water Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: 1'** >10' >10' Property line Building foundation Water main >10' >100' >10' Water Service line Surface water Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *From MOA files. **See Waiver OSP131401 . G. ENGINEER'S CERTIFICATION _1,13 OF A(,�S�1,1 I certifythat I have determined through field inspections and r: TH /4k -. ti/ review of Municipal records that the above systems are in •• •• •••;• (1.4(----1 conformance with MOA COSA guidelines in effect on this date. A T`�`` �- e Michael E. Anderson, P.E. 1 PF•Michael E.Anderson•�%j Engineer's Printed Name ,+I ku`9Fo Ro 0 ��r/ Date 7/13/2018 \�\N\"`� COSA brown sheet 10-10-12.doc try/1b/1ti1 ! 11:1_94 :::i-.:-:;F:.r' t'F_t At-1_1_15rout e • 2 I� ■■ I ■R■ ■MM■MI 111111116 1111 III I■ ■ ■ 'r ■ IIII III ■ANI II ■■ III 1111 ,■ ■ um OR III Eli ■ IIMM■ " NO ■ 1111■ Ura ti, „ dvan'TOxe Field Maintenance Report Annual Inspection AnchorageTank — - 907-272-3543 Properly Owrwr/Tracking ft Operator Robin Bassett Larry Betts Site Address Contact Phono 14727 W. Lake Ridge Terrace, Eagle River AK 99577 907-428-6060 AX Sho lb u County tO a Pod a Pau MIUL R oet0 at LAM InaUoctlon AX-100039 SW020100 200055 RTU100317 04/10/2016 Retrieve O&M Info ' Measure Sludge/Scum Daily flow Sludge Scum tat Curret ,l Previous r RecltC ratio Current Previous Timer Settings: 2nd Compartment Curront Previous Current Previous Please call ahead 229-8758 Inspect/Clean AdvanTex Filter _ Inspect Clean OdPerform Field Sampling/Observations o Normal — Pungent a atorals/Orifices Blomat , Normal 11 Excessive Pod Bottom i_ 1 NTU(15±NTUS) pH(8-9) DO(2-6) 1J� 3Bridging/Ponding: None/Minor Li Excessive Intake Vent I II l t6 (p Inspect/Clean Discharge Pump System Odor Of Sample Inspect Inspect Clean Typical /Musty Earthy LJ Moldy Riser/Lld C Floats Non-typical ,J Sulfide ❑CAbbage `I Decay Splice Box ❑ Pump Oily film in PVU I,IYes 17No Float cords J Foam in tank r ves I No Inspect/Service Other System Components Check Control Panel Inap Cle Inspect Cl9an _ Dialnfectlon Equipment U{ ,I Dispersal Laterals/Orifices 2 Recirc Amps Discharge Amps '7 - .i observation: ' t Additional Services Rendered Audible and visual alarms OK ❑Cleaned textile shEets? Li Replaced UV items? Dial tone(telemetry only) !J Yea y I No ReplaCed/USGd other Items? Parts Used:W,Warranty,B t--Billable(./appropriate selection) Inspect/Clean Pump System W B Item Number Description Inspect Clean Riser/Lid r Splice Box ) Float Cords — Floats Fin I/Safety Inspection Pump RSV reinstalled El Lids boned on 8{otUbe"Filter Manifold reconnected;flush valves closed [Ti Control panel reactivated Bictube Pump Vault Summary/Recommendation$ Recirculating Splitter Valve L System performing;no further action needed Tank needs pumping ❑Call for service [I Other? Comments 0, A i e L'.. 1'D LA 4 l P.. \ , 0 . r Signature �� . bet"! ,ir„�/ 1 c l Fax completed form to 1-866-384-7404 tam NEON ■■■a■a■ Vali ■■N325N N ■ ■ ■a a m. 6 me II IN a RIB Bill II a I ■ I ■ oim _, a■a III I ■ !MOO I I a all ■M■ mils A [dvartTexe Field Maintenance Report AnchorageTank Unscheduled 907-272-3543 P,.,pr?rty Ownarrrticaing I -• •• opY�YFo• __....._.-_-- Robin Bassett Arm Services, LLC - Site Mame Contact Mona 14727 W. Lake Ridge Terrace, Eagle River AK 99577 907-428-6060 J AX$119 ID a County 10 1 `Pod a RTU taut e _. pate Of last Willman 100089 SW020100 200055 RTU100317 09118/2017 Dispatcher Comments Cause of Malfunction:LJ Mechanical _.J Process-Related 10/17/2017 12:00 AM Date: - - •....._... — - Time: Please pump the septic tank. Notification of site condition Services Rendered: Made by VeriComm'Monitoring System Made by Homeowner ---.--- • ________- v-1/4 —.._..__ ! '+ . _.I Other_.. ..... - -- --_.... _. ._._.._ ... _ Site condition at time of call !_Alarm _�Tank Overflow — --- __...._--_---_----... Odur _.)Sewage Backup ,._;Other _ , .__________________ __.-__. Parts Used:W.Warranty,B=Billable(✓appropriate selection) Field Sampling/Observations w 8 Item Number Description Necessary `I Not necessary --_-- NTU(15 s NTUs) pH(6-9) DO(2-6) Odor of Semple. I _ _. ----- Typical 0 Musty U Earthy 0 Moldy Non-typical L Sulfide IJ Cabbage Li Decay Conditions at site Notes/Final Recommendations: Alarm On L.,YIN ;. . No If t [,System performing;no lurther action needed 1_]Additional service needed ( yes,alarm ype----,..-..----- 1 Tank Liquid Level Li Normal ❑lilgh ❑Low --------------•-•------ --.---..•-• Pump Onerational?0 Yes ID No Circuit Breakers Final/Safety Inspection: Pecirc D'hipped ( J On I.-J On Lids bolted on? L.1 Yes .1:1 No Discharge --I Topped r:._)On r,On Controls Tripped 17 On ON (If damaged,comment— _. ,.,._..- ._._ 1 Control Panel reactivated? •,j Yea LJ No VCOM°ATRTU Beards(if appl,cnbte) Document the panel status by shading the appropriate Circuit Breakers: inputs and outputs as indicated by the yellow and red LEDs. Renfro: n On 0 Off Discharge: L-}On .. •Off Controls: r, ;On . "Olt Inputs 000 ® ( ) 6 0 ® Time at Site Travel Time Total Tune Outputs 0 0 3 ® - -J.._.__---- - - --- •- --• LOff SSignature_. Power _On Li _•Flashing f` 611 )fi r (Green LED) "" f� '�"' _.-__----•- • ---. ��jj ` LLG ime `� L�_._. • Pate J'-�l- -I----__-.,...___.J..�--T --_fir...._ ...... Fax completed form to 1-866-384-7404 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT,herein the"AGREEMENT" made and entered into as of this /$ Day of ✓‘tlY of 2019 ,by and between Awry O i'errs Se-1.1,4.644ek ,herein the"OWER,"and the Municipality of Anchorage,herein the"MUNICIPALITY".in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein,the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the (h\ner to utilize and o erate an Advanced Wastewater Treatment System(AWWTS), described as wail-lel 4Ji/,d,"cecl eeiefride S located at(legal description) 2. Maintenance,Repairs and Alterations. (Owner is required to read,understand and initial each section) j,i., Throughout the term of this Agreement.the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall he maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. fp It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance,adjustment(s),replacement costs,and inspection costs. This includes an annual maintenance fee(typically $400 to$600). 1306-Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. (141-46rOwner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system,which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/1812018) Page 1 of 3 bk17-dirc Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. tbii� Owner acknowledges that the fine for failing to maintain and repair an AWWTS may he assessed in accordance with AMC 14.60.030. IYOwner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 4-, ,,i,, Owner agrees that any sale or transfer of title of the property will not occur without a new d Certificate of On-Site Systems Approval. i3/40i wner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. ty_atecaner agrees to maintain remote monitoring of the AWWTS as required by the ..AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system,or upon transfer of title,and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall he void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/1812018) Page 2 of 3 OWNER: BXliey $ I si nature) Date: 4Q:1e_, Afrry ,Sel/e0 fr,,a s (print name) ii-X t -70118 STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoin? instrument was acknowledged before me this/9 day of ")u,13 , 20f�3, by '••r S NO ARYPI-1'1,''mi"TR • AS • Commission expires: o-f/q /2 '1!7".':- omcial SEAL I _''` few iradlsad MUNICIPALITY: By: Abf/CeA atit o'ci (signature) Date: 7/30/02018 1 e e c ca (l cr'e 11 (print name) Title: (rev. 05/18/2018) Page 3 of 3 I Lot 21 I 8475X 30 S89°54'00"E 225.00 h 0 24.0 5 r CC N Q co N Garage N w 0 N Shore line X C- 24.0 u- t" Q I 00 -~Z. 34.: LOT 22 cc w W It °tS Gravel driveway , O bW W cv co3 o 0o 355 co j O ,n F4.0 OH 00 1 y �? dock rame1/2 HouseStorN 6 Z 0 °° aa) _I S7 • 35.5 Septic system O Well r�yy----1y 0 r- r-• C11 06 (t 1 n n i 30 S89°54'00"E 230.00 Lot 23 ',._.•%.•:•% ``"`` AS-BUILT NO CORNERS SET THIS DATE OF '4 '1 ' I hereby certify that I have performed a Mortgagee's inspection . • • • • � q rt of the following described property:LOT 22, BLOCK 2, �P•' • •S!f- 1, LAKE RIDGE TERRACE SUBDIVISION sos L''• 49th i.. •9 O•/�•• •• •• •••• / Anchorage Recording Precinct,Alaska,and that the /��� improvements situated thereon are within the property lines •, .. and do not overlap or encroach on the property lying t adjacent thereto,that no improvements on the property lying I, � , lizabeth L. Walatka . � � c . r adjacent thereto encroach on the premises in question and s�F•• 8036 – LS ••• — that there are no roadways,transmission lines or other vS �Fa . . • . •'ap. visible easements on said property except as indicated SCALE: 1"= 30' t� 1 %OFessioOk- `A�Ato hereon. 1 r"`�� Dated at Anchorage,Alaska EASEMENTS OF RECORD, OTHER THAN 7-2. -lb . this 23rd day of JULY ,2018. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREONEngineers and Surveyors UNLESS OTHERWISE NOTED. FB 18-8, pg 5 BE 907-248-1666 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage,ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORIT'Y APPROVAL FOR A SINGLE FAHILY DWELLING · Parcel I.D. .,9ree-315-05 1. GENERAL INFORMATION Expiration Date: Completelegaldescdption LOT 22~ BLOCK 2; LAKE RIDGE TERRACE SUBDIVISION Location (site address or directions) 14727 WEST LAKERIDCE DRIVE * EAGLE RIVER~ AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JOHN RUSSELL Day phone 696-3375 14727 WEST LAKERIDGE DRIVE s EAGLE RIVER, AK 99577 Day phone, Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's wort~. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ 3,~75.~--,-at, or pdor to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority 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 vedfy that based on the information obtained from the Municipality of Anchorege 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 ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD. SUITE 2B * ANCHORAGE. AK 99504. Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 357-6179 Engineer's Comments: In conducting this evaluation. AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the perfon'nance of the system under the conditions encountered et the time of the test. and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate durtng the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee futura performance of the system, nor do they guarantee that there are no hidden defects or encroachmenta. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational raquiraments of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or par~y is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for ~ bedrooms. Disapproved· Conditional approval for bedrooms, with the fllowing stipulations: · ..... ' ,~_~. ~ ~_- ,,: ON-SITE ._ . WASTEWATER . Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department Bu~g Safety Divlsen On-Site Water & Wastewater Program 4700 Sou~t 8ragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 w~v.cLanchorage.ak.us (9O7) 343-79O4 Legal Description: A. WELL DATA Welt [~ PRIVATE HEALTH AUTHORITY APPROVAL CHECKLIST IAKE'RIDGE TERRACE S//D; LOT 22m BLOCK 2~ Parcel ID: *STATE CODE IN 1969 If A, B, or C provide PWSIDRt N//A Well Log (Y/N) NO Date completed APPROX 1969 Sanite~/seal (Y/N) YES Totatdepl~ 115+ It. Cassdto .30'+ lt. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Amenic: N//A mg./L B. SEPTIC/HOLDING TANK DATA Tank Type/Material *FIBERGLASS Tanksize 1500 gal. Number of Compertmente 2 Foundation cteanout (Y/N) YES Date of pumping NEW C. ABSORPTION FIELD DATA Depression over tank (Y/N) NO Pumper Wires property protected (Y/N) Casing height (abeve ground) AT INSPECTION 5/'22/2002 24 ft. 5.56 g.p.m. 050- 315--05 12 in. Date installed ~/I0-31/2o02 Soil rating {~lor ft~bdrm) 5.0 Length 25+ ~ Width 5.0 lt. Totaldepth *&o--~.2$fl. Eff. alosoq~tion area 250+ fl~ Monltoringtube YES Date of adequacy test NEW Results (Pass/Fall) - Fluid depth in absorption field before test - in. Water added - gal. Elapsed Time: - min. Final fluid depth - in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) - System type TRENCH Grovel below pipe 4.11 ft. Depression over field NO For 3 bedrooms New depth - in. - g.p.d. If yes, give date - Nitrate 0.2 mg./L. Other becterla 1 .colonies/100 mL Oate of sample: 4/11//2002 Collected by: AKWWC, INC. *'mis IS AN AOVANll~X TREATMENT SYSTEM Date installed 5//10-31//2002 Cleanouta (Y/N) YES High water alarm (Y/N) YES D. UFT STATION Date installed 5/10-31/2002 · "Pu/np on" I~vel at'l]UER in. Datum Bo'FroM OF TANK E. SEPARATION DISTANCES Size in gallons 1500 "Pump off' level at'13MERIn. Cycles tested NEW Manhole/Access (Y/N) YES High water alarm level et 46 in. Meets alarm & circuit requirements?. YES SEPARATION DISTANCES FROM WELL ON LOT TO: Septt~ tank/Iift station on lot100'+ Absorption field on lot 100'+ Public sewer main N,/A SeWer/septic service line 25'+ *WNVE~ REQUESTED On a~jacent lots. '82' On adjacent lots. 100'+ Public seWer manhole/claanout N/A Holding tank N,/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water service line 10'+ Wells on adjaCent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *'1 '+ Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS Building foundation 10'+ Surface water 100'+ Wells on adjacent lots 100'+ Absorption field 5'+ Surface water 100'+ **WAIVER ~rWR020100 · Water main N/A D~veway, parking/vehicle storage G. ENGINEER'S CERTIFICATION 10'+ I certify that I h~e'determined through field inspections and review of Municipal recon~s that the above systems em in conformance with MOA HAA guidelines in effecf on this date. Eng!neer's P. rinted Name JEFFREY A. ORRNESS Date of Payment Receipt Number (Rev 12~01) WaKer Fee $ Date of Payment Receipt Number 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 January 27, 1987 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 22; Block 2; Lake Ridge Terrace Subdivision Location (address or directions) (b) (c) Applicant Name John Russell Telephone: Home 688-3375 Business Applicant Address 14727 Westlake Ridge, Eagle River, Alaska 99577 Applicant is (check one): Lending Institution []; Owner/builder ¢('1; Buyer [] Other [] (explain); (d) Lending Institution Northland Mortgage Telephone Address Eagle River, Alaska (e) Real Estate Company and Agent none/refinan~ng Address Telephone (f) ~a~he HAAtothefollowingaddress: S ~ g EN¢INEERING ~7034 Eagl~ R~u~r Loo? Road~ Su~£e 204 Eagle ~ue.~= A£az~a 99577 TYPE OF RESIDENCE SinglezFamily'~ Multi-Family Number of Bedrooms Other WATER SUPPLY Individual Well ¢1 Community [] Public [] Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~( Public [] Community [] 'Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 ~ ,[o ?, @~d '~JOM s.JeeU!bU@ leUO!SS@JoJd eql u! sue!ss!u Jo Jo sJoJJe JoJ @lq!suodseJ leu s! abeJoqouv JO Xliled!o!un!Ai @ql 'penss! s! eleo!J!Pe3 e eJojaq mep eZ/~leUe Jo suo!~oedsu! lonpuoo ~ou op ds]HC] jo see,~oldLU3 's~ueLueJ!nbeJ reels pue leJepe~ u!epeo ,~Js!~es el JepJo u! suo!lnu~su! 6u!puei J!eql pue seuJoq jo sJeseqoJnd o~ Xsepnoo e se s!q~ seep dS]Ha eqL 'm~Sel¥ ~o e~B~S eql u! peJels¢~eJ Jeeu!bue leUO!SSejoJd ~uepuedepu! ue ,~q e^oqe ~ qdeJ§~Jed u! ue^i8 suo!~mueseJdeJ eql uodn/~lelOS peseq seleo!b!peo leAOJddv ,~uJoqlnv qUe@H senss! (dS]HQ) uo!lom, OJd ImU@LUUOJ!^US] pue queen bo lu@Lu~edea @eeJoqouv jo ,~uled!ounlAI eqJ. 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OF HEALTh MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTiONHEALTH AUTHORITY APPROVAL (HAA) · ?,l 2 g lg87 ' CHECKLIST- FEBRUARY 1984 264-4720 RECEIVED Legal Description: WELL DATA Well Classification Well Log Present (Y~b~ Total Depth I'"¥¢~ ~ ~ Cased to Static Water Level ,~-'..5'-- ! Casing Height Above Ground Electrical Wiring in Conduit ((~/N) Separation Distances from Well: If A, B, C, D.E.C. Approved (Y/N) Date Completed ~ ~ ,/~/~/'~ '~' Yield~ ~ ~ Depth of Grouting Pump Set At / ~" Sanitary Seal on Casing ~)'N) Depression Around Wellhead (Y/~ To Septic/~Tank on Lot ~ ~'¢ ! ~ ; On Adjoining Lots ,~o To Nearest Edge of Absorption Field on Lot / 0 ~/ '/ ~n, Adjoining Lots /~-~ To Nearest Public Sewer Line ,~fZ/''¢- To Nearest Public Sewer Cleanout/Manhole ~ / ~ To Nearest Sewer Service Line on Lot / - Water Sample Collected by ~<h~:f'---~ L~;~-/~'~'~''r'-'~-'//''~'(''' ;Date ¢~_.Z..~:~,'7/ . Water Sample Test Results ~ ¢~t~'~''t ~'~N-C"~-'~( Comments '-~ ~./z~. t/~_,> /'~=~,p--=cp_~ c~_~-~'G, ~'/¢¢- ~/~/"h¢-~ B. SEPTIC/HOLDING TANK DATA Date Installed ~-~-~ Size icrc, c=, No. of Compartments Standpipes ~¢~, N) Air-tight Caps (l~N) Foundation Cleanout Depression over Tank (Y/~J Date Last Pumped ? ~ Z Pu mping/Maintenance Contract on File (Y/N) .__ ~w//,cZ~ ;for - Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course Comments ~ / ,,~¢.cJ. To Building Foundation To Disposal Field / To Stream, Pond, Lake, or Major Drainage Page I of 2 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~' - ~. -/-¢ I 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 Lot L~,/~_ Type of System Design Length of Field /"~ !/ Depth of Field _g.~'. ~'- Gravel Bed Thickness "'--- ~'/O 4~ Standpipes Present I~N) Date of Last Adequacy Test To Property Line /cb !~- To Existing or Abandoned System on ; On Adjoining Lots To Water Main/Service Line /O/-f- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all//MOA and HAA guidelines in effect on the date of this inspection. Si~;~l&d$ ~=NGINEERING Date //~--.~/~ ~ C 17034 Eagle RlYer Loop Road No. 204 o_rnp n . - ..... . Eag~ ~lver, Alas~i~ ~,,77 MOA No. Receipt No. ~00 ¢ ¢ 00~ Date of Payment f-- ~ ~ --~ Z Amount: $ ~O ' O 0 Page 2 of 2 72-026 (11/84) L..r v DATE RECEIVED INSPECTION APPOINTMENTS DATE DATE DATE ~ I NSPECTOR~ INSPECTOR MUNIOIPALITY OF ANOHORAGE ENVIRONMENTAL pR~l~lON DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~ ~ Telephone 264-472~ REQUEST FOR ~PPROVAL O~ I~DIVI~U~L WATER ~ S~ER ~CILITIES 1. PROPER~Y OWNER . ~ PHONE MAI L~NG ADDRESS PHOPE~TY ~E~'IDENT {If d~ff. rent fram ~bove) 4 ' PHONE MAILING ADDRESS 3, LENDING INSTITUTION ~ PHONE MA~ ~I~G ADDreSS 4. REALTOR/AGENT I PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION /..,¢ ,,¢,z, STREET LOOATION 6. TYPE OF RESIDENCE E~SING LE FAMILY F-I MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five J~/'~h re e [] Six [] Other 7. WATER SUP.~I;H-Y I~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled p~io_~t~ th,at date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM I~"~INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE ACC PAN'~ EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FiVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [~] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED []PUBL,C UT, L,TY Connection Verified INSTALLER E~]Septic_Tank or []Holding Tank Size: /~'-)~) If Tank is homemade SOILS RATING give dimensions: TYPEOFTANK MANUFACTURER ~-A~' ~-'O~, TQTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line / I Absorption Area to nearest Lot Line 5. COMMENTS ~.~"'AP P R O V E D FOR .-~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY