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HomeMy WebLinkAboutSOUTH LAKEWOOD HILLS BLK 2 LT 9South Lakewood Hills Block 2 Lot 9 #015-511-22 Development Services Department Building Safety Division ® On -Site Water & Wastewater Program *A9 4700 Elmore RoadP.O. Box 196650Mark Be 9ich Anchorage, AK 99507 Mayor www:muni.org/onsite _ (9D7)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description Property Owner Name & Address: �vµx�. -[-fie t��.. }4L lfs ���'•`' K.uuaso•J- ��Do o rr�ivrciEY �'A 13.2.. 1 % ".5-D17 Pump Installation Date: Pump IntakB Depth Below Top of Well Casing.,Wfeet Pump. Manufacturer's Name: hob 737at� r Pump Model: GAT $S/416 Pump Size 3�/ hp Pitless Adapter Burial Depth: 4 feet Pitless Adapter Manufacturer's Name: yVJp y1 w15s.f Pitless Adapter Installer: aY+ Well Disinfected Upon Completion?Yes ❑ No Method of Disin%etion: C47— n' � Comments: ANCHORAGE WELL & PUMP SERV. ANINEPPump Installer Name: 330 EAST 767" AVENUE ANCHORAGE, AK 99518 AWPS.CO14. PHONE: 907-243-0740 Attention: The pump installer shall ptdwwa-a pump installation log to the DSD within 30 days of pump installation. I, I.IrIGIiIIV I, RG�IV,I-J-�-iZAV{i Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 4 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141023 PID Number: 015-511-22 Dwelling: ❑i Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New N Upgrade Name: FRANK NOBLE ABSORPTION FIELD El Deep Trench 9Shallow Trench ❑Bed ❑Mound Address 6900 O'MALLEY RD., ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 3.0 GPD/SF 7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original gradeGravel 4 Ft. depth beneath pipe 3.0 Ft. Subdivision Block Lot SOUTH LAKEWOOD HILLS 2 9 Fill added above original grade 2_2,5 Ft. Gravel length 20 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines NA Distance between lines i NA Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 172 Ftp 1 NA Ft. well >50'* >90'* NA NA >25' TANK ■ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water >100' >100' NA NA Material Number of compartments Lot Line >5' >5'* NA NA STEEL 2 NA Foundation >5' >10' NA NA LIFT STATION Manufacturer Capacity Curtain Drain >50' >50' NA NA Gal. Remarks EXISTING SEPTIC SYSTEM ABANDONED Pump on level at in. Pump off level at in. High water alarm at in. PER UPC REQUIREMENTS * WAIVER ON FILE Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfieltl A+ HOME SERVICES Drainfield F810 C0/MTF810 Inspector LARS SPURKLAND BENCH MARK (Assumed elevation)100 It Inspeection t& 2125/14 2/27/14 Location and description ction V 2/28/14 2" 4" 3/4/14 TOP BASEMENT STAIRS RETAINING WALL COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date yP. it 4 Tt :../S 1..... .. ... ... i r RE.SPURKLANC:4� 0 � � Approved iG%. D c- Dated " � ®- 1 j `\�a F`�N" I, I.IrIGIiIIV I, RG�IV,I-J-�-iZAV{i C-\ INSTALLED 3 -BEDROOM SEPTIC SYSTEM SWING TIES A 8 INSTALL 1500 ADVANTEX TANK W/ S. I. C.O. C 23' S0' X 20 FILTER S. I. M.H. D 30' 59' Sim- 10X TRENCH LENGTH 20 FEET DF. C.O. E 59' 80' TRENCH WIDTH 5 FEET DF. MT. F 61' 82' ROCK DEPTH 3.0 FEET DF. C.O. G 72' 87' DF. MT. H 7590'� 61 VSULATION OVER UNDERNEATH DR LOT 8 R C9 LOT 9 SOUTH LAKEV OD HILLS NBLOCK 2 NOTE. SLOPES EXCEEDING 25X WERE NOT 08SERVED '7 WITHIN 50 f££T DOWN GRADIENT OF THE PROPOSED ABSORPTION FIELD LOCAOOM q X• NOTE.• THIS 1S NOT A SURVEYED PLAT. WELL k SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 25 0 25 50 75 100 125 150 SCALE., 1' = 50 FT, O'MALLEY ROAD LOT 10 SPURKLAND U 0 5YUNKLANU LN-1NttKINb; I ( sou7yl LAII�'WOOD HILLS IYK z L7' 9 I I RECORD DRAWING 203 W TH. AVENUE ANCH. AK.K9950FRANK NOBLE DATE, MARCH 4, 2014 1 (907) 279-3916 6900 DWALL£Y RD., ANCHORAGE, AK 99516 SHEET., 173 GRID: 2639 PERMIT N OSPI41023 PID At 015-511-22 SL VHB2L9SC50ASBBVG 6" F 1500 GALLON ADVANTEX TANK "q�� RENON MARK TOP STAIR PETAMNNG WALL ASSUMED ELEVATM 100 PURKLAND 0 IJNUHKLANIJ LNV1NLLK1NL3 I I SOUTH LAHNVOD HILLS BLK 2 LOT 9 I I RECORD DRAWING I 203 W15th Ave FRANK NOBLE 279-3916 DATE: MARCH 4, 2014 Anchorage Ak 99501 6900 O`M4UEY ROAD, ANCHORAGE, AK 99516 SHEET+ P/3 GRID; 2639 PERMIT # 17SP141023 PARCEL ID # 015-511-22 SL WNB2L9D3ASB, DV& T.H. /1 E.G. EL£V.=89.9' Elev.=85.7' Elev.=827' H2O ELEV.=74.4' (2/25/14) B.O.H. ELEV.=72.9' To Advantex Unit Cleanout / Monitor 5-Wlde Trench: 4' F810 5' Wide 20' Long 7' Max Depth 30' Sewer rock 20.0' 3.0 Ft of Septic Rock Effective NO SCALE WALL I JYUKKLRN1) tNU1NGLKINU I I SOUTH LAKEWOOD HILLS 203 WISth Ave ELK 2 LT 9 I I RECORD DRAWING I FRANK NaBLE DATE: MARCH 4, 2014 Anchorage Ak 99501 6900 01HALLEY AVAB, ANCtO"GE, AK 99516 SMEET. 9/9 GRID @694 16 Anchorage I PERMIT # DSPI41023 PARCEL ID # 015-511-22 SL WHB2L 9DASB4.DW6 I On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141023 Tax Code Number: 01551122000 Work Type: Septic Upgrade Permit Effective Dates: February 24, 2014 to February 24, 2015 Design Engineer: SPURKLAND ENGINEERING Subdivision: SOUTH LAKEWOOD HILLS Site Legal Address: SOUTH LAKEWOOD HILLS BLK 2 LT 9 G:2639 Owner/Address: NOBLE FRANK EUGENE & KARIANE 6900 OWALLEY RD ANCHORAGE AK 995077061 Site Mailing Address: 6900 O'MALLEY RD, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank 2�2S�r-f Zp•� Lot Size in Sq Ft: 35100 Total Bedrooms: 3 N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: Municipality of Anchorage tK� � P.O. Box 196650 • 4700 Elmore Road Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 Department http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141024 COSA#: Permit#:OSP141023 PID#:015-511-22 Legal Description: South Lakewood Hills, Block 2, Lot 9 Engineer: Spurkland Engineering Applicant: Frank Noble Your request for a waiver to allow the following minimum separation distances is approved: • Advantex AWWTS Septic Tank to Well: 50 feet • Absorption Field to Well: 90 feet • Absorption Field to Property Line: 5 feet This waiver approval applies to the proposed septic tank and absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ® Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. .........................................................0.0............x0..... Waiver is Granted: X Waiver is not Granted: Date: ? Approved b . Name of Reviewer ........................................... 4.1/................................. MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division C6 Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcell.D. 015-511-22 Property owner(s) FRANK NOBLE Mailing address 6900 O'MALLEY RD., ANCHORAGE, AK 99516 Site address SAME Day phone 947-3758 Legal description (Sub'd., Block & Lot) SOUTH LAKEWOOD HILLS BLOCK 2 LOT 9 Legal description (Township, Range & Section) Lot Size APPLICATION IS FOR: (El all that apply) Absorption Field ❑ Septic Tank El Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Ft. Number of Bedrooms 3 APPLICATION IS AN: Initial ❑ Upgrade 0 Renewal ❑ SurMT, FFP3 TYPE OF DWELLING: Single Family (SF) 0 (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: WELL TO TANK, WELL TO FIELD, FIELD TO PROPERTY LINE Distance: 50,90,5 I certify that the above information is correct. I further certify that this is in accordance with Permit/Rush Fees: 511!�t — Waiver Fees: Date of Payment: Date of Payment: 441,019 Receipt Number: 634g21 Receipt Number: 6 Permit No. n'P ly 1 3 Waiver No. GS V 114 102 Permit App_9-1-12.doc SPUTMand EngonesTong Environmental Consulting and Design L SEPTIC SYSTEM DESIGN SOUTH LAKEWOOD HILLS BLK 2 LT 9 Municipality of Anchorage February 18, 2013 Development Services Department On Site Water and Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 Subject: Septic System Installation Permit 6900 O'Malley Road Ladies and Gentlemen: I am writing to request a septic system installation permit for the above referenced property. The existing septic system is in the O'Malley Road ROW and DOT would not issue a letter of Non - Objection. The proposed system will serve a 3 -bedroom single-family residence. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: Groundwater observed at a depth of 15 feet below ground surface (2/18/14). Soil Rating. From Testhole 2/11/14 1.6 min/in = Maximum Application Rate 3.0 gal per sq.ft/day With advanced wastewater treatment No. of Bedrooms Required Area per Bedroom: 15013.0 =50 sq.ft. Total area required: 50 x 3 = 150 sqft Use Shallow Trench with 3.0 feet effective depth Trench Length = 150/50*0.58— 17.4 ft. System: We are proposing a 1250 gallon Advantex AWWTS followed by a shallow trench absorption field. The absorption field will be 20 feet long, 5 feet wide and contain 3.0 feet (172 sq.ft. effective) of sewer rock. Soils: A test hole was excavated on February 11, 2014. See the attached soil logs. Ground water monitoring will continue through construction of the septic system. Groundwater was observed at a depth of 15 feet below ground surface on Feb. 181h, 2014. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net to Environmental Consulting and Design Surface Water: There are no surface waters within one hundred feet of the proposed septic system upgrade. Topography: The ground level slopes down towards the northwest. No cutbanks or slope greater than 25% we observed within 50 feet of the proposed drain field. Waivers: Advantex AWWTS Tank to Well- 50 Feet Drain field to Well -90 feet Drain field to Property Line- 5 Feet With this submittal we are applying for a waiver of the 100 foot separation distance required between the proposed septic system and the private well on the above referenced property. The existing septic tank was installed prior to 1973 when required the well to septic tank separation distance was 50 feet. Due to existing development patterns and a limited area for the septic system replacement the septic tank and field cannot be located outside of the 100 foot well radius. A well log for the above referenced property was not located. On August 30, 2013 the static water level was observed at 185 feet below the top of the well casing. Steady pumping of 490 gallons of water from the well at a maximum output of 5.2 gpm caused a drawdown of 0 feet. Water samples collected from the exterior hose faucet on October 30'', 2013. Water quality analysis for bacteria, nitrate and arsenic showed negative for coliform or other bacteria, 2.07 mg/l for nitrate and below detection limits for Arsenic. The nearest legible well log is for Lot 2 Block 2 Stoney Brook, a neighboring property to the southeast. According to the well driller's log, the well on this was drilled on November 17'h, 1983, has a total depth of 210 feet, a static water level of 78 feet below the top of the casing, and a yield of 5+ gpm. The well log records layers of sand and gravel between the aquifer and the surface. A layer of clay was observed from 15 to 22. Clay layers act as an impermeable barrier protecting the aquifer from contamination from septic system effluent. Well logs for South Lakewood Hills Blk 2 Lot 5,7 and Stoney Brook Blk 2 Lot 2 are included for your review. The original septic system was installed in July of 1973. The existing system consists of a 1250 gallon steel septic tank and an 8 x 8 x 6 foot crib. The septic tank is located approximately 50'+ from the well. The drain field is located approximately 110 feet from the well, but is not on the property. Soil logs indicate the following site conditions: a shallow layer of organics/silt/loam; 3.5 feet of sandy silty gravel fill, a layer of silt, clean sand and then sandy silt to a depth of 17 feet. Ground water was observed during the excavation. After the seven day monitoring period the ground water level was at 15 feet below the ground surface. 203 West 15`" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Environmental Consulting and Design Mitigating Factors: The well head for lot 9 is located up gradient from the septic tank. If the septic tank were to overflow, it would drain away from the well head, making surface flow contamination from the septic system impossible. The water bearing strata is at a depth of 185+ feet. Layers of sand and clay appear to be present. This should protect the aquifer from subsurface contamination. The existing septic system has been in place for 40 years and water quality samples collected on August 30", 2013 meet minimum drinking water standards. Water quality results are included for your review. The proposed system is a cat III nitrogen reducing advanced wastewater treatment system. A maintenance agreement will ensure that the system is monitored and maintained. The chance of the septic tank leaking effluent into the substrata is very unlikely. The highly treated effluent and a minimum separation distance of 90 feet from the drain field to the well ensure that public health and safety are protected. We would also like to request a lot line waiver for the proposed absorption field. The proposed field will encroach 5 feet into the 10 foot lot line setback. The property to the north is DOT ROW and the property to the west is private. A signed and notarized letter from the private property owner is included for your review. Granting this waiver will not adversely impact either of the neighboring properties The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or need additional information, please contact me at 279-3916. Sincerely, cjcl� Lars Skland, P.E. Civil Engineer 203 West 15`" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Environmental Consulting and Design Municipality of Anchorage February 13th, 2014 Development Services Department On Site Water and Wastewater Program 4700 Elmore Rd. Anchorage, Alaska 99519 Subject: Septic System Installation Permit South Lakewood Hills Block 2 Lot 9 Ladies and Gentlemen: I am the owner of South Lakewood Hills Block 2 Lot 8. On February 13, 2014 I was notified that a waiver of the required separation distance between a septic system absorption field and our shared lot line was requested by Frank Noble, owner of South Lakewood Hills Block 2 Lot 9. Sincerely, /eeftsouih Ciikewood Hills Block 2 Lot V 4, 7: Notary Public TERRI M.DAUGHERTY State of Alaska My Commission Expires Jun 6. 2016 203 West 15th Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Ills%�I�►i I LOT 8 I LOT 10 4 u LOT 9 0 SOUTH L A K E V 0 D H I L L S® o _BLOCK v� 3 LOTLOTLOT Z aK STNBocKPBRaI NOTE. THIS 1S NOT A SURVEYED PLAT. WELL A' SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 50 0 50 100 150 200 250 300 SCALE; 1' = 100 FT. SPURKLAND ENGINEERING ( SOUTH LMEWOOD HILLS BK 2 LT 9 I (SEPTIC SYSTEM DESIGN 203 V 15TH. AVENUE FRANK NOBLE DATE., FEB. 18TH, 2014 ANCH. AK. 99501 (907) 279-3916 6900 DWALL£Y RD., ANCHORAGE, AK 99516 SHEET., 1/4 GRID: 2639 PERMIT # DSPIl10XX PID If 015-511-22 SLWHB2L9SC100DVG INSTALL 3-8EDR00M SEPTIC SYSTEM INSTALL 1250 ADVANT£X TANK W/ sicre - m- mi X 20 FILTER TRENCH LENGTH 20 FEET j9VALLEY ROAD TRENCH WIDTH 5 FEET ROCK DEPTH 3.0 FEET COVER 4 FEET MIN SOUTH N 1-1 L A K E W H I L L S 25 0 25 50 75 100 125 150 SCALE 1' = 50 FT ISPURKIAND ENGINEERING I I SOUTH LAKETYOOD HILLS BK 2 LT 9 I I SEPTIC SYSTEM DESIGN 203 W K.995D7 TH. AVENUE ANCH. AK FRANK NVBLE DATE, FEB. 16TH, 2014 (907) 279-3916 6900 D'MALLEY RD., ANCHORAGE, AK 99516 SHEET: 2/4 &RIB, 2639 PERMIT # LISPI21OXX PID # 015-511-22 SLWHB2L9SC50.BWG 6" CAP ADVANTEX AX20 POD ` 24" ® INSULATED RISER 6" PUMP -OUT OPTIONAL SLIDE SECTION OF 6" PIPE J OVER THIS CONNECTION TO PROVIDE SHEER PROTECTION_ EXTEND TO BRIDGE EXCAVATION 1250 GALLON ADVANT£X TANK L JYUKKLHNIJ LNLIINLLK1NLi I I SOUTH LAKETYOOD HILLS BLK 2 LOT 9 I I SEPTIC SYSTEM SCHEMATIC 203 W15Ave FRANK NOBLE DATE* FEB. 18, 2014 Anchoragege Ak 99501 279-3916 6900 OWAUEY ROAD, ANCHORAGE, AK 99516 SHEET, 3/4 GRID; 2639 PERMIT # Z79PIJIXXX PARCEL ID # 015-511-22 SLkWHB2L90,DWG 4' F810 To Advantex Unit Cleanout / Monitor 200' 5 -Wide Trench: 5' Wide 20' Long 7' Max Depth 3.0' Sewer rock 4' Cover 3.0 Ft of' Septic Rock Effective NO SCALE ISPURKLAND ENGINEERINGI I SOUTH LAKEWOOD HILLS BLK 2 LT 9 I I SEPTIC SYSTEM SCHEMATIC I 203 W15th Ave FRANK NOBLE DATE: FEB. 18, 2014 Anchorage Ak 99501 6900 O'MALL£Y ROAD, ANCHORAGE, AK 99516 SHEET: 4/4 GRID: 2639 279-3916 PERMIT # OSPIXXXX PARCEL ID # 015-511-22 SLWHB2L9D4,DWG I Spurkland Engineering 203 W.15thAve. Ste. 202A Anchorage, AK99501 TEST HOLE I L_ DEPTH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SOIL LOG AND PERCOLATION TEST SOIL DESCRIPTION DATE_£g&-11._2QL4 ORGANICS WAS GROUNDWATER OBSERVED: Yes__ IF YES, AT WHAT DEPTH: 16.5' _ AFTER MONITORING PERIOD: 15 DATE OBSERVED: __ 2 -18 Sandy, Silly Gravel, rill PERCOLATION TEST - (GM) Some organics Silt NO Sand (SP) Sandy Silt NO 8.0.H. NOTES.• FILL DATE I GROSS TIME NET TIME DISTANCE DROP 6.000 2 11 14 12:15 PM 0 min. 6.000" 12:21 PM 6m 30s 0.000 6.000 6.000 12.28 PM 7m 30s. 0.000 6.000 6.000 1236 PM Bm 05s 0.000 6.000 6.000 12.,45 PM 8m Ms. 0.000 6 000 6.000 1255 PM 9m 20s 0.000 6.000 PERCOLATION RATE. • 1.6 minutes/ inch PERC HOLE DIAMETER: 6 inches TEST RUN BETWEEN 5 _ FT AND 6 FT SITE PLAN: PERFORMED BY. Lars Spurkland, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. SPURKLAND ENGINEERING SOUTH LAKEWOOD HILLS BLK 2 LT 9 SOIL LOG PERCOLATION TEST 203 V 15TH. AVENUE FRANK NOBLE BATE.- FEB. 11, 2014 ANCH. AK. 99501 (907) 279-3916 6900 O'MALLEY ROAD, ANCHORAGE, AK 99516 GRID #+ 2639 PERMIT # OSP141XXX PID # 015-511-22 14 SPUTMand ENDO MCTMO Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: SOUTH LAKEWOOD HILLS BLK 2 LOT 9 Date: February 18, 2014 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the project includes the procurement and installation of a 3 -bedroom on- site wastewater disposal system at the location depicted on the attached site plan drawings. The scope of the work also includes the installation of an Advantex 1250 gallon tank, an AX -20 treatment pod, and a drain field comprised of 1 trench, 5 -feet wide x 20 -feet long, a maximum of 7 feet deep, 3.0 feet of septic rock below the distribution piping. The location of the drain field is shown on the attached site plan drawings. The total depth of the field will be 7 feet below the existing ground surface. All components of the proposed septic system must be constructed a minimum of 100 feet from any surface water and 90 feet from water well on the referenced property. All other wells must be greater than 100 feet from closest portion of septic system. A minimum of 4 feet of earthen cover is required over the septic tank and a minimum of 4 feet of cover is required over the drain field. In addition to the required earthen cover, 2 -inch thick, 40 psi, direct bury board foam shall be installed directly over all installed piping beneath driveway areas. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net to spuftind Elmohmc�whnu Environmental Consulting and Design 7. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used in the Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. Septic Tank Installation: 1. A new septic tank, of the size specified in the design drawings, shall be procured from a qualified manufacture/supplier if the existing septic tank is found to be defective. 2. The burial rating of the tank shall be adequate for the actual burial depth encountered. 3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 4. All standpipes on the tank shall extend a minimum of 12 inches above the final grade. S. Tanks installed with less than 4 feet of cover shall be insulated. 6. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. 7. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be sufficiently compacted to prevent future settlement of the soil. 8. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. 9. A cleanout shall be installed 1 to 4 feet from the foundation. 10. Post tank cleanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 13. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained where required by the MOA. 15. The contractor shall verify that the septi ctank/lift station is a minimum of 50 feet from the residential water well on the referenced property, 100 feet from any other private wells, 150' from any class'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. 16. The contractor shall remove or abandon the existing tank in compliance with the Uniform Plumbing Code. Drain field Construction: 1. The drain field shall be excavated to the dimensions outlined in the design drawings. If any discrepancies are noted, contact the engineer immediately for clarification. 2. The drain field shall be installed parallel to slope contours. 203 West 15`h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net difilk Sp Mafld Efl once ong Environmental Consulting and Design 16M 1 7=1 3. The bottom of the drain field shall be within 2" of level. If the sidewalis or bottom of the excavation become smeared, they must be raked or scarified prior to the placement of filter sand or drain rock. 4. The drain field must be a minimum of 5 feet from the test hole excavation. S. Distribution pipe is to be installed level with perforations facing downward, atop a level bed of drain field rock. Septic rock shall then be placed atop the distribution piping to provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping. 6. A silt barrier must be installed at between the final drain rock and the native soil backfill. The silt barrier shall cover the entire drain rock surface. 7. Monitor tubes must be 4" in diameter, installed in the locations depicted on the design drawings, and extend a minimum of 12" above final grade. The portion of the monitoring tube below the septic rock must be perforated and the portion above the drain rock shall be solid. 8. Backfill over the final gravel layer must not be less than 2 feet. Insulation must be installed when the backfill depth is less than 3 feet. 9. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. 10. The contractor shall verify that the drain field is a minimum of 90 feet from the residential water well on the referenced property, 100' from any other private residential well, 150' from any class'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. Inspections: 1. A minimum of two inspections are required by the Municipality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The first inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be backfilled. 3. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any backfill. 4. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparing the record drawings. S. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net SGS Re£# 1135392001 Client Name Spurkland Engineering Project Name/# South Lakewood Hills B2 L9 Client Sample ID South Lakewood Hills B2 L9 Matrix Drinking Water Sample Remarks: Printed DatefTime 11/05/2013 16:39 Collected Date/Time 10/30/2013 11:30 Received Dateffime 10/30/2013 15:54 Technical Director Stephen C. Ede Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date [nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 10/31/13 11/01/13 ACF Waters Department Total Nitrate/Nitrite-N 2.07 0.100 mg/L SM21 4500NO3-F B (<10) 11/01/13 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM21 9223B A 10/30/13 SDP Total Coliform Negative 1 100mL SM21 9223B A 10/30/13 SEP nGRE'1ER ANCHORAGE AREA BOP` JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ,/ ^� NAM / 2 lJ MAILING ADDRESS -512 A '8 o X PHONE 3//7 - 77S"/ Sy LOCATION6e ��14 � %%} Z LEGAL DESCRIPTION— M-�.7��i 'ea t 1 J1" i 7t SEPTIC TANK: DISTANCE/0 NUMBER OF FROM WELL �_MANUFACTURER �slck• MATERIAL --�f«L COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I (QUID CAPACITY/2SO GALLONS. SEEPAGE PIT: , i Pep;^%crc-2 NUMBER OF PITS r DIAMETER —OR T WIDTH_, LENGTH_, DEPTH / , LINING MATERIAL toy Cal b CRIB SIZE(R $&IAMETER_DEPTH–L/DISTANCE FROM: WELL 1 � r) TOTAL EFFECTIVE !J� BUILDING FOUNDATION NEAREST LOT LINE_` ABSORPTION AREA (WALL AREA) _,e-;22_SQ. FT. ADDITIONAL ABSORPTION WELL: /N -co, b , Cv o5T2 u GTI -O IJ TYPE J CONSTRUCTION R BUILDING ,/ NEAREST 2 O Ir NEARESTSEPTIC FOUNDATION LOT LINE , SEWER LINE ._._ , CESSPOOL .__. OTHER SOURCES APPROVED ✓ DISAPPROVED REMARKS DEPTH �O I * TANK , DISTANCE FROM: SEEPAGE `) O ,� SYSTEM , , DISTANCES: DIAGRAM OF SYSTEM 12jC'1'L Ems) 3y� ZOC P INSTALLED BY: R� 225 PIPE MATERIAL: r I - LOT SLOPE: `�• `"" ' I ZI, REMARKS: DATE� PPROVEd�L Z/A,-za25S1[tth"14- G.A.A.B. Form No. EQ -031 GREATER ANCHORAGE AREA BOROUGH r• Y' 4r ,{+< DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 •'C" STREET ANCHORAGE. ALASKA 99303 TELEPHONE 2744561 .... SEWAGE DISPOSAL SYSTEM — APPLICATION ANDPERMIT NAME OF APPLICANT So MAILING Ay DRESS ! PHONE' INSTALLATION LOCATIOµI� O M'1 G /�p S /OY[�I/P U Q ✓ ✓e LEGAL DESCRIPTION wee cl INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF F/ FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE A FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /Z50 TYPEI-! p EEPAGE AREA SIZE TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK S/ FOUNDATION TO SEEPAGE PIT `O DRAIN FIELD I SEPTIC TANK TO SEEPAGE PIT WALL e 4 o y SEPTIC TANK / 5 � r h/' . 0-,1 / nP SEEPAGE PIT J ORAIN FI[E�LD TO NEAREST LOT LINE. W P II C/a'✓1 G.� CC�/ /�//� WELLTO SEPTIC TANK �Q SEEPAGE PIT /00 DRAIN FIELD ALSO CONSIDER AREA WELLS. O / / WATER MAIN TO SEPTIC TANK / .SEEPAGE PIT /D DRAIN FIELD SEPTIC TANK. SEEPAGE PIT O`er DRAIN FIELD TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER A CHORAGEE AREA BOROUGH ORJD/JNANCE ". 28• 8 AND THAT THE DESCRIEy D BY TEM 16 IN ACCORDANCE WITH SAID CODE. ��'1 C )�OCh 44 7 jo•y-,, h !!l Z�/ l �� /L �,, P 0%/`� DA / APPLICANT'S SIGNATUR�IC FORM HO. O-01 1 V GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case N 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed ForKelso.j, Dated Performed 74h:3 Legal Description: Lot___y_Block�;2_Subdivisions/4k,,,,.y,,z //,.ids This Form Reports Soils Log 1( Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14— Was Ground Water Encountered? If Yes, At What Depth? mmmmmmm mmmmmmm� MM®MM�� mmmw Reading Date Gross Time Net Time Depth to H2O Net Drop r e rcuja Liun Kd Le minute Proposed Installation: Seepage PitDrain Field Depth of Inlet Depth to Bottom o Pit or TrencFiT— COMMENTS: Test Performed BY s- Date Certified BY: Date: r 1 ell Planning and Zoning Comp„fission Minutes Page 2 Special Meeting: April 19, 1973 alert to the construction industry and to the populace prior to the advent of the construction season, to prevent speculation which any such proposed regulation can bring, and to assure a wide discussion of the problem. These objectives were obtained. As far as timing was concerned, it entered into some of the discussion. They wanted to have the adoption during the Legislative Session. You may have noticed that there were three sets of proposed regulations which were advertised while the Legislature was in session. This was to enable the Legislature to have a full look at them during the Session. From the standpoint of water pollution from sewage disposal, he could say that no community in the State of Alaska today meets the requirements of the Federal Clean Water Act. It is very doubtful if any of the communities in Alaska will meet the 1977 deadline, as required under the Clean Water Act, or the 1983 deadline. With regard to the requirements required by 1985, the State of Alaska would be lucky to meet them by the year 1085. This information has been passed on to Mr. Ruckelshaus. We should look at some of these deadlines and at the actual situation in the State. There are at least five climatic areas, each with its problems, ranging from the Pacific to the Arctic. There are special problems concerned with each of the areas and each problem differs from the problems envisioned by the people in the Congress as they were preparing the Clean Water Act. This act was prepared with the ideas of New Jersey in mind and then applied to Alaska. In the case of the 40,000 sq. ft. for on -lot water and sewer, one can look back on the Public Health Service studies recommendation to the State Legislature in 1965. This stated that under conditions of soils and sands having ideal percolation rates and under conditions of warm soils with a reasonable length of winter, 40,000 sq. ft. was the minimum recommended size. In the State of Alaska, the soils are not warm; the so81s are often silt, jumbled soils or wind-blown silt all of which do not give good percolation tests. In some areas there is very heavy rainfall which mitigates against the proper operation of a septic tank system. In a great deal of the State permafrost conditions exist. In short, none of the ideal conditions exist. Speaking in generalities, the best area for on -lot water and sewer is in the Matanuska Valley. As one goes north or south from the Matanusak Valley, things become continually worse. They have no illusions that 40,000 sq. ft. would take care of the problems in Alaska. Under the most Ideal conditions, it might help solve some of the problems. On the other hand, when one looks at the question of the disposal of sewage here in Alaska there are two choices: (1) to provide water and sewer, or (2) to make the lot size sufficiently large that the lot itself has a fair chance of providing sufficient area for sewage disposal with proper separation from the water supply. This is something which will not come over night. the idea of the 40,000 sq. ft. was an attempt at the first step. If they were to go ahead and assume 40,000 (one acre) for the Matanuska Valley, they would have to say that in many areas of Alaska, on -lot water and sewage disposal is not a satisfactory method. The regulation as written would not have caused difficulty for the northern and western parts of Alaska as they do not have on -lot water and sewer. Water is hauled in 46 1 O�1 7 V --> / Z S ly. �o f % j�7k 27 sotcf�i a ke w rrcel 110".e P/P// I p a &s P tFStT7� sPu P` � 1 e PUgAI • • G rt. 9V •,'��_ Municipality of Anchorage 46 On-Site Water and Wastewater Program 4 R e (907) 343-7904 54 ETY Certificate of On-Site Systems Approval Parcel I.D. 015-511-22 Expiration Date: 1 -19 1. GENERAL INFORMATION: Complete legal description South Lakewood Hills;Block 2, Lot 9 Location (site address) 6900 O'Malley Rd*Anchorage,AK 99516 Current Property owner(s) John Knudson Day phone 307-899-0061 Mailing address 6900 O'Malley Rd*Anchorage,AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ ��7) Waiver Fee $ iDate of Payment 572-1 fn Date of Payment Receipt Number G, 3.5(� Receipt Number COSA# Q JaQi 1 77 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 East Tudor Road,Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: C.ii 1)til' In conducting this evaluation.GEG provided an engineering evaluation of the well and/or septic system 5; n� ' ,, in accordance with the guidelines and regulations established by the Municipality of Anchorage and 4i��.••••.•• •• ;^, cI� industry practices. The reported results describe the condition of the system/s on the date/s of the ? • %4--fi , evaluation. Separation distances were measured to readily identifiable features. Hidden defects or • N� ••'� 'iris encroachments may exist that were not identified during the evaluation. The operational life of all wells v ••7i�!; and septic systems depend upon 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 .. .. .Ai are outside the control of GEG. Satisfactory test results do not guarantee future performance of the /AA r f r„ (/ system/s; therefore,GEG makes no warranty(express or implied)regarding the future performance of I/O-7,1 Cr X93 • • D the well or septic system. GEG makes no representation whether an alternative well or septic system C 9 i e, 4 can be installed on the property in the event either of the current systems fail to perform adequately in ��• . ••./. ,f�t,-a the future. The content of this report is for the sole benefit of the person/party that retained GEG to \ii\OC�'-c• perform the evaluation. Reliance upon the information provided in this report by any other person or �Q� ��o�' party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE , 1/40Q� j,SY OFrr����i��� System#1 Approved for bedrooms ti��G• ,sOi-Joi System#2 Approved for bedrooms _`�J ON-SITE Disapproved o WATER AND m WAS. Conditional approval for bedrooms, with the fot5 t s iogps. R 2 )'71111111110ile `1 All By: `-2 �� Original Certificate Date: 5--E1-19' 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Slue sheet_16-1 U•12.00c COSA Checklist Legal Description: South Lakewood Hills; Block 2, Lot 9 Parcel ID: 015-511-22 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system_ A. WELL DATA ❑Well log is filed with Onsite (or attached) Well production at time of test 3.6+ gpm Date drilled 1973(') Water storage tank volume Na gallons Total depth *208+ ft Well disinfected for coliform test? ❑Yes 0 No Cased to unk ftX Coliform bacteria is Negative El Sanitary seal is functioning correctly Nitrate 2.70 mg/L ❑ Nitrate less than MRL (ND) Q Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL(ND) Casing height(above ground) 18+ in. Collected by GEG, LTD. Date of flow test for COSA 5113/19 Date of Sample 5/8/19 Static water level at beginning of test 190 ft. Comments *Per 2016 pump installation log B. TANK DATA Tank liquid levels were not checked C. LIFT STATION Age of tank(s) 5 years Required maintenance completed Tank type/material " " Age of lift station 5 years Standpipes/foundation cleanout per record drawing Lift station material steel Date of pumping * Comments: C,' ..2' *See attached Advantex maintenance report D. ABSORPTION FIELD DATA Advantex system Which system tested (date installed) 2014 Adequacy test date 5113119 ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 8.91 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 4.75+ft(min) Water added 609 gal ❑ N/A—pressurized field New depth 17 in X Monitor tubes go to bottom of drainfield. If not, state Elapsed time 1185 min depth into effective X Code-required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) NO date of test) Gallons introduced N/A gallons If yes, enter date N/A Comments/Deficiencies:House was vacant until 5/6/19 COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' „50,+ Community Sewer Manhole/Cleanout> 100' Yes if No ft Q✓ Yes if No ft * Neighboring Tank> 100' EYes if No ft Private Sewer/Septic Line > 25' Q✓ Yes if No ft Absorption Field on Lot> 100' ❑Yes if No ..50+ ft Holding Tank> 100' E Yes if No ft Neighboring Absorption Fields> 100' * Animal Containment> 50' ['Yes if No ft El Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [1]Yes if No ft EYes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' 0Yes if No ft Surface Water> 100' ❑Yes if No ..50+ ft Property Line> 5' EYes if No ft Driveway/Parking > 0' E Yes if No, comment Absorption Field > 5' EYes if No ft Wells on Adjacent Lots: Water Main > 10' Q,/ Yes if No ft Private Wells > 100' ❑Yes if No **50'4- ft Water Service Line> 10' 0✓ Yes if No ft Community Wells>200' ✓❑Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E✓ Yes if No ft Driveway/Parking >0' E Yes if No, comment Property Line> 10' ❑Yes if No «..5+ ft Wells on Adjacent Lots: Water Main > 10' Q✓ Yes if No ft Private Wells > 100' 0 Yes if No —50'+ ft Water Service Line> 10' 0 Yes if No ft Community Wells>200' 0 Yes if No ft Surface Water> 100' 0Yes if No ..50+ ft F. ENGINEER'S COMMENTS *Caveat: Sump for trench on South Lakewood Hills; B2, L10 could not be found **Advantex system • ***WR#141024 do6o�p‘; Q4 OFA X0.4 G. ENGINEER'S CERTIFICATION o •s4�� po ;.... • I certify that I have determined through field inspections and review ! v� ••• / ! of Municipal records that the above systems are in conformance with i c�: , 9H ►, MOA COSA guidelines in effect on this date. i Q "i.. 0 1 :t : A. Gornes p0 CE 7• 3 .:-pf19,• '' COSA Checklist yellow sheet ,%\.,, �c resstQ�o NAECC88< kO�oo • 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 thisfti i3 Day of /l'lcrj of 20/q , by and between (ec GI•tto h , herein the"OWNER,"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 Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 4d v a h f e x located at(legal description) './co 'Mq// le04,1 ,ztv,� r���,J� "sc� 2. Maintenance,Repairs and Alterations. ,. (Owner is required to read, understand and initial each section) 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 be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in , p accordance with the equipment's approval for operation in the Municipality. / 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 A includes an annual maintenance fee(typically$400 to $600). % Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, ti► repairs or permitted alterations to the system. +t� Owner 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/l8/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. nay 'V Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. 1 Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. WL Owner agrees that any sale or transfer of title of the property will not occur without a new L Certificate of On-Site Systems Approval. `(-N�(�l Owner 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. U Owner 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 be 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. 05/18/2018) Page 2 of 3 OWNER: iBy: ��tk (signature) Date: S- ! 3 - / "7-P S1A4 Ifiz in (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this . r`'`'day of i\r\k J`;i 20 ri , by 44 Ml In Inwi c .101041; c • ' KA. 1 My Commission expires: (? a-9- /(9099-0 1 NOTARY) ‘0.40tfi .\PUIILIC 4.. MUNICIPALITY: BY:_______A_ t'''' .-- ---- (signature) Date: Ed (print name) Title: (rev. 05/18/2018) Page 3 of 3 06/15/2018 05:21 8686770 APLUS PAGE 08 • 318852 II M{i i1<MiMMi i ii*ii■ i■ R■ ■ ■ Baena I Eta ii M tilt i I MOSS Imo M1R I ROO 1 _loss * M*Miiii �eTan�: ver ® Field Maintenance Report An T 7 -354.3 Annual Inspection oo.�t� pmp,„tyOwnseTtPoieng' Larry Betts ..-- John Knudsen 307.899-0061 $ee MxlmfData OI llrx lmgec�e++ 6900 O'Malley Road,Anchorage AK 99507 1, courtly rode cou0711712017 rxtor 418109 AX-X-133999 OSP141023 Measure Sludge/Scum Scum -^ Retrieve O&M Into sludge Current Previous Dally now ---.._] ReC rc ratio ® Currant Previous 2nd ComPrnient Current Timer Settings: L----- Inspect/Clean ___,InspecVClean AdvraynTex Filter Inspect art Odor 7' Il,Normal ❑Pungent LBtCraIgtOrrice6 7D 0Nome! 0Exosssive Pod Bottom Perform Field Sampling/ObservationsBiomet: � �� rani(ts a NTUv) pH(6-9) DO(2-� Bi dg!n9/Ponding: K,None/Minor 0 Excessive Intake Vent 1 1 I i} . L � Inspect/Claan Discharge Pump System Inspect (lean y /� inspect Odor of SampleRieertid 0 Floats 0 0 typical Musty j�Earthy ❑MAY Splice Box 0 Pump 0 0 Non-typical Sulfide 0 Cabbage 0 Doty Float cords oily nim In PW ❑Yes ,;No Foam �JYoa No Inspect/Service Other System Components Inspect Clean bullpen': Mart Check Control Panel _ Disinfection Equipment �Dispersal Latsrals/OrInces Pedro Amps Discharge Amps Observations 0 -_'� 10. 2— Additional Services Refidared rpt 0 Cleaned textile sheets? E Raplaosd UV items? • Audible and visual slam+$ OK 0 RoplacedlUsod other horns?Dial tone(telemetry only) ❑Yes TTTTT�No Parts Used:W c Warranty,13=Billable(✓appropriate selection) Inspect/Clean Pump system w B item Number Description Inspect Clean — T Riser/Lid )2:-,. Box Float Corda Floats/ FinaUSafety Inspection Pump }[J RSV reinstalled s boltEd on Biotube• (J'( Meni(dd rttomnaded:titch veivea dosed :intro: bopalletIivated Biotuha Pump VaukrSummery/ReoommettdatiorssRecirculating Splitter Valve ❑Systempeltomtiruxnoturthoract onneeded ❑ k needs pumping • ❑Call for service Comments_ ❑OtheR ,,, Srgr.uty� !'tel — y :���� � + Fax completed form to 1,866-384-Deto404 4a- f ;.4-1---: L- E: `1.1 ,C:i.1-=-. 1----' =52 5.5=1, \f f -- .Z.;o- '7' _ "i\ N 8- @• '' ,.gam- Lic SE,P✓F',t_S f . .. eri-/ SGPf.0 , 4!e•-�� e.•J fn:.r • , • a., �s 213 _ 31777:7:-.77.- It 1 0 +r " We f '' �.�,L - <Ir. ct� r .•b o Wo k,:ip . e, hl • ,, _ .l L/ 4 f EP9., M 0 __ �/ N `� f�,,j-( e. , i o. o f 21' •2,1 ..q Z. . o x " O `�carporfA 2 NI • 35; : e o r OT O Lai .-- 0 —. L o'r (U _ • /. c,e 5 � — - - — ^,: ;'<l-,' 11-3-1 3 if Lecekt3-3-!4Z/' S8'8q-5e„-.A1 - l2(o_oa"ccerkr{rid 4-?-c?o 6-rl� A S a u I L-,- tA.R.v-e No Car.,,e,s Scr' I hereby certify that I have surveyed the following described property: T I } 3 L�k-�C. f So-rr L.4�trWaSD !- ILLS 5c4� U,'; � , *CkLAJ Anchorage Recording Precinct Alaska, and that the improvements situated thereon are within the property T 0.3253 S lines and do not overlap or encroach on the property ii• lying adjacent thereto, that no improvements on prop- erty".•: lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except • as indicated hereon. ALE:. I =90' Dated at Anchorage, Alaska ASEMENTS OF RECORD, OTHER THAN 7% this }4 ` day of M A E7 C 14- 197? HOSE SHOWN ON THE RECORDED FRED WALATKA & ASSOCIATES LAT ARE NOT SHOWN HEREON.• Engineers and Surveyors moi✓ 7Z-!z P (0-1 O MUNICIPALITY • DEPARTMENT OF HEALTHTH & 8 HUMAN SERVICES 1 Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D, If HAA # 1. 1. GENERAL INFORMATION , Complete legal description L%ey4 q, 2�KQ Sno '"ut eek -el' Location (site address or directions) r Property owner Y0,144 21010-a Day phone Xb2— 1i*3 Q Q' 'Mailing address Lending agency Mailing address. Agent Address _ Day phone Unless otherwise requested, HAA will be held for pickup. - 2. NUMBER OF BEDROOMS: ........ ........ ,...... ... _ ... .... -----_.... _.. 3. TYPE OF WATER SUPPLY: Individual well _ ..._...•_._�._.....,�.........__.__ Community welt .�,..Ye.__ .. . Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system.- 4. ystem. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank , Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rw.1/91) Front MOA121 u. rav *" (lNl •A0u1 WD -U -Niom s)aau!6ua leuo!ssajoJd eyl u! suo!ss!wo Jo sioJJa Jol apsuodsaJ IOU s1 e6eJo143uy to A3!led!o!unyy ey1 'pansi s! eleo!pwaa a eJolaq elep Wpm Jo suolloadsul lonpuoa IOU OPSHH4losaaftdw3 sluaLuannbaislelspueleJapalu!upaoApilesolJapJou!suollnigsul6ulpua!naylpue sawoy10sJmpindol(sapnooeses!y3saOPSHH(3sy1'e)lselyloalelSeylu!paJalsl6aJJaau!6ualeuo!ssapid - luapuedapu! ue Aq enoge S ydeJ6eJed ul uaA16 suolleluasaJdaJ eyl uodn Aluo paseq saleollpaO lenaddy Ajpoyiny ylleaH sanssl (SHH4) sao!AJaS uewnl.i pue y3le9H to luawyedao e6eJoyouy to dl!led!olunyy ey1 :suo!lelnd!is 6u!mollol ayl yl!m 'swooJpaq oleo sluawwoo Ieuo!jppy JOl IEAOJdde ledop puoC).. -_,-• _ -. 'panoJddes!o •swooJpaq Jol panaddy R; 3unIVN°JIS SHHO - '9 aJnleu6ls sdaeu!6u3 R ssaJPPV suoyd ITP, o wnd to eweN _ 'uo!loadsul s!yl to elep eyl uo loal;a u! suo!ieln6aJ pue 'seoueulpJo 'sapoo eielS pue led!o!unlry Ile yl!m eoue!Idwoo ui s! wals (s lesods!p Jalemalsem Jo/pue J(Iddns Jalem ells-uo ayi 'uo!loadsut pue uo!le6lisDAui J(w woJl pue sal!l e6eJoyouy to J(i!led!o!unyq eyl woJl pau!elgo uo!lmiolut eyl uo paseq leyi Al!JaAJaylJnl I -u!aJay paleo!pui ainloruls to ad/4 pue swooJpaq to Jagwnu ayl Jol elenbape pus Ieuo!lounl'ales s! wags (s lesods!p Jalemalsem Jo/pue Alddns Jalem ei!s-uo eyi ieyl smogs uo!leo!ldde IenoJddy J(i!Joylny yileaH s!yi to uo1ie61.isanu1 Aw leyl /l!JaA I 'molaq umoys alep uo!lep!IeA ayl to se pue olaJay pax!lle Inas Aw Aq pa!l!iJao sy H33NION3 AS N01103dSN1 d0 1N3W31V1S 'S Municipality of Anchorage Department of Health & Human Services AECM law HEALTH AUTHORITY APPROVAL CHECKLIST EFTIS Legal Description: 1-61-9,8K.2 Parcel I.D. So 0c c. �-�. ,�,�••aPN;lis A. WELL DATA Well type SES If A, B, or C, attach ADEC letter Log present (Y/N) ^) Date completed _ ADEC water system number Driller Total depth 1Act Cased to I FS., 2- Casing height a& " Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTIONZ .0 Date'of test . Q j Eca Static water level 8 y N .-� LJ.J Well flow0 g.p.m. -� W g.p,m < to .-. — LU 18a rZ Pump level ' n LLJ •. ..t Z SEPARATION DISTANCES FROM WELL TO: z Septic/heldin tank on lot b-3 ; On adjacent lots > 111-0 Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout NZA Public sewer service line NSA Petroleum tank` B WATER SAMPLE RESULTS: Coliform //J Nitrate 0 - (0 11L Other bacteria Date of sample: At%'q Z Collected by:S B. SEPTIC/HOLDING TANK DATA Date Installed Y/,3/ is Tank size 1; a Compartments OIL Cleanouts (Y/N) ONIF Foundation cleanout (Y/N) %� Depression (Y/N), High water alarm (Y/N) // 11//e4ln l Alarm tested p (Y/N) t\ A- Dateofpumping. 818791 K-o�o Loop ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ' 413 On adjacent lots > I ay Foundation Z O To property line 50 ' Absorptionfield t16 Water main/service line d ! Surface water/drainage NZA 72-M JR". map Fwt Moi 21 CONTINUED ON BACK PAGE C. LIFT STATION Date Installed ,:NoNLE- Size in gallons — Vent(Y/N) High water alarm level "Pump on" levet at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: . Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water 17 Date Installed TXX/ Soil rating N o K►tt/W1q System type -1-0 h Cm b ngih Width 1k Gravel thickness t7 Total depth ,.Total absorption area 5 Z 2- Cleanouts present (Y/N) Depression over field (Y/N) _� Date of adequacy test R/I I?f =Results (pass/fail) �ct� S lrs-r for bedrooms Peroxide treatment (pas) 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot II I Onadjacentlots �Propertyline ( Z To building foundation To existing or abandoned system on lot N�^- Onadjacent lots NA Cutbank NZA Water main/service line �2 S� Surface water Driveway, Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION ( I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. Signature 1 i`.•' i"ae Engineer's Name l o l.�O.t �t �D v �k ( K cQ ( �,� • - .;:.:' , Date 13 I c( °t I i`i �`'; r << C HAA Fee $ Waiver Fee: $ Date of Payment Date of Payment Receipt Number Receipt Number 72-M (A". 3191) Bock MOA 21 T _ E;F=U FRKLIaND P _ I=- 203 203 NEST 15YH. AVENUE SUITE 206 ANCHORAGE, ALASKA 99502-3904 (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: Lot 9, Block 2 South Lakewood Hills LOCATION: 6900 O'Malley a OWNER: Marvin Ebnet k, I RESIDENCE: Single Family, 4 Bedrooms WELL: Private, On Site SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: 4 -Bedroom System TANK: Stack Steel 1250 Gal. Two Comparts. ABSORPTION SYSTEM: Crib ABSORPTION AREA: 522 Sq. Ft. SOIL RATING: 125 INSTALLATION DATE: 7/13/73 DATE OF LAST PUMPING: Roto Rooter August S, 1991 DATE OF TEST: August 1, 1991 I TEST PROCEDURE: System was inspected and measured. Tank was found with 4 feet of cover and with a liquid level of 44 inches. Crib was 9.5 feet deep and dry. A clean out was located 31 feet distant from the crib. This clean out was 7.5 feet deep and dry. Present owner does not know what this clean out is. The crib was presoaked with 2000 gal. of clean water. This caused a water depth of 31 inches to be observed. 20 hours later the crib was dry. 650 gallons of clean water was added to the crib while the water levels in the tank and the crib tube were monitored. The water level in the tank did not change, while the level in the crib rose 13 inches. During the next hour the water level dropped 5 inches.. The next. day the crib was dry. Indicating that all the water had been absorbed. At no time was water observed in the "unknown" clean out. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants. 4C:OR� ........` SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: 4 -Bedroom System TANK: Stack Steel 1250 Gal. Two Comparts. ABSORPTION SYSTEM: Crib ABSORPTION AREA: 522 Sq. Ft. SOIL RATING: 125 INSTALLATION DATE: 7/13/73 DATE OF LAST PUMPING: Roto Rooter August S, 1991 DATE OF TEST: August 1, 1991 I TEST PROCEDURE: System was inspected and measured. Tank was found with 4 feet of cover and with a liquid level of 44 inches. Crib was 9.5 feet deep and dry. A clean out was located 31 feet distant from the crib. This clean out was 7.5 feet deep and dry. Present owner does not know what this clean out is. The crib was presoaked with 2000 gal. of clean water. This caused a water depth of 31 inches to be observed. 20 hours later the crib was dry. 650 gallons of clean water was added to the crib while the water levels in the tank and the crib tube were monitored. The water level in the tank did not change, while the level in the crib rose 13 inches. During the next hour the water level dropped 5 inches.. The next. day the crib was dry. Indicating that all the water had been absorbed. At no time was water observed in the "unknown" clean out. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants. CHEMICAL & GEOLOGICAL LABORATORY f =� A DIVISION OF COMMERCIAL TESTINO & ENGINEERING CO. •-eo.-,o„ b633 [i STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 5e2-2343 FAX: (907) 551.5301 ANALISIS REPORI By SIMPLE fat WORRordsrt 36787 Data Report Printed: AUC 8 91 4 13:36 Client Sample ID:L9 82 SOUTH LAKE WOOD RILLS Client Mame :TOBBEN 3PURELIND. P.B. PWSID :UA Client lett :IOBBEMS Collected AUC 1 91 4 14:40 hrs. BPO B PO I NONE RECEIVED Rewind LUG 1 91 1 15:50 his. Req 8 Pisnryed with :13 REQUIRED Ordered By :TOEBEN SPURELIND lnalysis Completed :IOC 2 91 Sand Reports to: Laboratory Supervisor :STEPHEN C. EDE 1)TOBBEM SPURRLAND. P.L. Rel a and By : 2) Chemlab Ref 8: 913831 Lab Sapl ID: 3 Parameter Tested ----------------------- MITRIIE-M Sample ROUTINE SAMPLE COLLECIED BI: STUART. Remarks: Matrix: NITER Iseult Unita Method ----------------------------------- 0.62 mq/l EPA 353.2 Allowable Limits 10 - --•• - -• --••--•- •--- ----•---•--- 1 TeetsPerformed Sea Spacial Instructionslbore 01 -Unavailable MD- Mone Detected " Sao Sample Remarks Above Ml- Not Analyzed LT -Lan Than, CT -Creator Than rvl sr3s Member of the SGS Group (SOCI616 Gdndrale de Surveillance) I Mr. Neil Nelson BRA Box 359 -Anchorage, Alaska, 99507 Tobben Spurkland P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 SLVER ADErUACY TEST MUNICIPALITY OF ANCHORAGE DEPT. OF I-..:ALTH & ENVIRONMENT.=L i - ,I CTION LOT 9 BLOCK 2 SOUTH IAISF.'WOOD HILLS Residence. 4 bedrooms, finished, built in 1973 Water System On site well Bower System 1250 gal tank Log Crib 8x8x6 Absorption Area 522 sq -ft. Date of Test Jan. 229 1980 in311980 RECEIVED January 249 1980 Test Procedure 5 inches of water was measured in crib prior to test. The crib was charged with 1500 gal. of water which caused of the water level to rise 23 inches. After 24 hours the level had dropped 21 inches. • `' �� Percolation rate is: 1500 A23--- 1300 c. Pe Re Required rc rate is 600 q — --This system is adequate. - I � , I r � I — � I Note: There was no indication that there was an hydraulic conection between the crib and the road ditch (>'1IALA: L=`1 T2cNV) 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS tat a La+ TIME IQ. eta e w7 Ll, A. DIME TIME vv1. 4, 0`78INGLE FAMILY ❑ One ❑ Four ❑ Other DATE DATE DATE �L-1 a-1 7. WATER SUPPLY INSPECTOR .. INSPECTOR .. INSPECTOR since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) SYSTEM S. SEWAG,�E, wlrlml ITY OF ANCHORAGE YEAR ON-SITE SYSTEM WAS INSTALLED. DEPT. OF H_ALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION -\ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION • 1 825 L Street - Anchorage, Alaska 99501 OrnGl, 7979 1 J J ENVIRONMENTAL SANITATION DIVISION Telephone 2644720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE /V.e r I k . - L(.. m. .015"N MAILING ADDRESS S +,c r I? -F- A 13 o x 3 ,— PROPERTY RESIDENT (If different from above) PHONE )N, 1 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 0. REALTOR/AGENT PHONE MAILINGADDRESS - 5. LEGAL DESCRIPTION Sa- )_.L w d ,U,1ls tat a La+ STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS 0`78INGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY [Three ❑ Six 7. WATER SUPPLY 0� INDIVIDUAL' 'ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) SYSTEM S. SEWAG,�E, �DIS:POSAL L7 INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEDL 72010 (Rev. 6/791r `,w,.,r.�•1j - 1— 15 S a �i 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY ` 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS Cl ONE ❑ TWO ❑ THREE ' ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMITNUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED �3 INSTALLER ❑Septicc Tank or ❑ Holding Tank Size:I -L�.c-_SnkIf Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL f J 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [/APPROVED FOR 2 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must acc M—DISAPPROVED C_ any certificate) DATE —3 I — -4 — BY r- 72010 (Rev. 6/79) GREATER ANCHCRAdE AREA POROIJGH Oenartment of Environmental Qualitv 9500 Taaor Road, Anchorage, Alaska 94507 279-9696 Date Received o2 -a G - Tide of Insoection - Date of Ins nection „1 -)7-'� ? PE'YJEST FOR APE;ROYAL OF IWITVnJAL SEVER S WATEP. FACILITIES FOR n 1. Acrrov*l Requested 9v: ,�G i er�� ;Z779SIC Address:Q Zao �93�J9 phone:,27y r3 /f P 2. P-onsrty Owner: a : O _ _ jnT�` Phone: 1 % �� �l./ LLQ I �Y— 4 ?. Lecat Dwgcriotion: (f C b,,,._n.g- rV CD A, Location. `(12�,� zul- G�da�C'Ji-ed �e-L �/ CG�;�, •mit.' x'33"7_- r 5. Tune of Facility t0 hq In3pert.ed: ' Number of Redro%rs: 3 6, Well Data: A. Tvne_-d4, Q t- _ B. Depth C. Cnnetructio f— D. Rectorial Analysis 7. Sewage Disnosal Svstea: �,J A. C. 6� D. Installed Septic Tank: 1. Size Seepage Pit: 1.. Size 3. Installer 2. Manufacturer 2. Material S. Disposal Field: Total Lergth of Lines 3. Distances: i A. Well To: Sentic Tank 7 Z___-, Absorntion Area Sewer Lines q;,rost Lot 'Ano , Other Contamination 3. Frn:ndetinn t^ ^tic T?nk i Absorntien Ar -a C. Aosoretinn Area to tleare:t Lot Line 6X'11 1,- N��twlae &H- ABTA �Recpject for Anoroval of _,.,idual Sewer &.Water Facilit._: Page Two 9. C�cwnt;: Annrw-! d Date An••rn:•al 'Valid for One Year Fro-,, Date Si�nPd Gr-ato- Anchorage Are:) Inrov^h. Nrartrent of Enviromental Quality DT.AC-?A"! OF SYSM!. I certif- tl.at the inforration con'.alnea in this request for approval to he a true ani acriratA rrore�cr.tatino of the sq'n;art sew,�r and Hater facilities located at: Signed Date GREATER ANCHORAGE AREA BOROUGH D le, FROM: DEPARTMENT: INITIATED BY: DATE OF MEMO: DATE ANSWER TO: DEPARTMENT: 010 REQUESTED: RECEIVER: A90 --------- REQUESTED ACTION SCHEDULE 10 FOR INFORMATION ONLY FOR IMMEDIATE ACTION FOR YOUR CONSIDERATION OTHER PREPARE BACK-UP INFORMATION CALL ME BEFORE YOU ANSWER NEED YOUR RECOMMENDATION A, A, Al 73. CW aAO ------ - --- r Gp/ is `ank Oe,ll .17epti, - /8j �eef is f a.vee Xpa l /.moo Ga lS. Wel/ fo — 'J8 ecf 126" I March 7. 1973 Lois Greenwald Coast Mortgage Company P. 0. Box 1200 Anchorage, Alaska 99510 Subject: Sewer and water facilities for Lot 9, Block 2, South Lakewood Hills Subdivision Dear Mrs. Greenwald: The sewer and water facilities on the above lot has been investigated for an approval for a Conventional loan. The well is of approved construction and the water analysis was satisfactory. Our files show no record' of the sewer' system .serving this lot. A detailed drawing of a sewage system has been submitted and signed by Mr. Harvey Packer and notarized by a Notary Public. It is stated by Mr. Packer that he saw -the sewer system up- graded in April of 1970 and could therefore, attest to what it Includes. This office has accepted Mr. Packer's drawing and will give a final approval of the sewer and water facilities on this lot when the following requirements are met: 1) The distance between the well and septic tank is rdquired to be 100 feet as is stated in the Emergency Regulations put into effect February 5. 1973, by the State Department of Environmental Conservation. A waiver from, this same Department will be necessary and must be received by our Department before final approval can be made. 2) The seepage pit. according to Mr. Packer's drawing is also too close to the well and to the septic tank. The seep- age pit must be 100 -feet from the well and 15 feet from the tank. It is required that the seepage pit be moved in order to meet these requirements. Final apprvG oval can be given if this office receives a copy of an escrow of funds for the purpose of moving the seepage pit to meet Borough requirements no later than August 1, 1973. A permit must be acquired at this office before reinstallation is begun Lois Greenwald March 7, 1973 Page Two If you have any questions concerning this matters please do not hesitate to call this office at 274-4561. Sincerely. Denise C. Bashaw Environmental Control Officer' kt cc: Neil K. Nelson. I, Harvey Packer, was a witness in April, 1970 of the excavation and installation of a new addition to the house and line to the septic tank. And that the figures on the attached page arc accurate to the best of my knowledge. The contractor was Roy McCoy. At this time I was a resident of the C. F. Nicholas home. Original installation made in 1965 and the home has been used as a duplex up until the present. The present sewer system has never presented any problems. Dated this,5-aday of March, 1973. Harvey Pack STATE OF ALASKA ) THIRD DISTRICT ) ss. THIS IS TO CERTIFY that on this,5-ckday of March, 1973, before me, the undersigned Notary Public duly commissioned and sworn, personally appeared HARVEY PACKER, known to me and to me known to be the person named in and who executed the foregoing; and they each acknowledged that they signed the same freely and voluntarily, for the uses therein stated. WITNESS my hand and seal. Notapr Public My Commission expires: r`"", Coast Mortgage Co, Alaska Office • 700 "G" Street - Anchorage, Alaska 99501 - (907) 274.3619 March 71 1973 GREATER ANCHORAGE AREA BOROUGH Enviromental Qualities Section 3500 Tudor Road Anchorage, Alaska Re: Lot 9 Block 2, South Lakewood Hills Sub. NHN O'Malley Road ' Gentlemen: We are holding $20500 in a Time Certificate of Deposit for the repair and inspection of the individual water and sewer system on the above captioned property. i The completion date is to be August 1, 1973. Sincerely, Charles E. Hom Vice President CEH:1g Another financial service of Marine Bancorporation. SUME or uWILLIAM A. EGAN, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION / SOUTNCENTRAL REGIONAL OFFICE MACKAY BLDG. 338 DENALI STREET March B, 1973. ANCHORAGE 99501 Mr. Doyle E. Currier 3202 Spenard Road Anchorage, Alaska 99503 SUBJECT: Lot 9, Block 2, South Lakewood Hills Subdivision Dear Mr. Currier: As this waste disposal system was in the ground prior to February 5, 1973 and money has been escrowed to make corrections to bring the system up to current GAAB-DEQ and State Standards, we have no objection to the transfer of ownership. Yours truly, Kyl I:�-d'. IrCy Regional Environmental Engineer KJC/cg cc: GAAB-DEQ