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HomeMy WebLinkAboutOSMOND OLSEN LT 3 kncv vuiucr 10f Municipality of Anchorage On -Site Water and Wastewater Section e (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231010 PID Number: 012-242-36 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New FM Upgrade Name LATTO ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 7655 JEWEL LAKE RD, ❑ other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot OSMOND OLSEN LT 3 Fill added above original grade Ft Gravel length Ft Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 100'+ 50'+ TANK ❑Q Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity GREER TANK/ANCH TANK 1250 Gal. Surface Water 100'+ Material Number of compartments Lot Line 10'+ NA PLASTIC 2 Foundation 101+ LIFT STATION Manufacturer Capacity Remarks TANK DEMO PER UPC, Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield MIKE N ANDERSON, P.E. Drainfield CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft Inspdection 1st 2/24/23 Location and description 2 TOP OF MANHOLE 3'a 4m ON-SITE WATER AND WASTEWATER SECTION APPROVAL E_ngirteQr'kStamp ., a yam• 1' Conditional Approval: Date R n, • e .. a a e e e� e��. e•. e 'f Septic System Approved f Date 3 3 Z�Z e e e e o e� e e a • e e •sea • rAICHAR N. rt.DtRSCN % '� : �� CE - 9469 .' er %°,'; . ••,= ,� 2. Note: this approval does not include well permit requirements. kncv vuiucr 10f Permit No. OSP231010 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: OSMOND OLSEN LT 3 PID No.: 012-242-36 11 / -X MARK A B C01 15 62 TC01 18 55 TCO2 22 52 CO2 24 50 CO3 25 50 C04 67 15 C05 T 58 75 I I ® I WELL x I I I I I I I — — I C04 BENCH, MANHOLE LID I II fl NEW 1250 GALLON PLASTIC TANK II I II 3 II II I 71 IJCO5/MT ASBUILT SCALE: 1"=50' F Al GRADE ELEV. 100 .�` AV �••� AN 49 TH SEPI SEC71ON N.T.S. W MICHAEL N. ANDERSON: No. CE 9469 X11 '�O ••'•... ...•.•• ••� a soooo3E 124.1 124.1S00003E MUNICIPALITY OF ANCHORAGE rvNenr On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road i. Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite I)e1)21I'tI lent. On -Site Wastewater Disposal System Permit Permit Number: OSP231010 Effective Date: 2/21/2023 Work Type: SepticTank Upgrade Expiration Date: 2/21/2024 Tax Code Number: 01224236000 Site Legal Address: OSMOND OLSEN LT 3 G:2226 Site Mailing Address: 7655 JEWEL LAKE RD, Anchorage Owner: LATTO ROBERT & VERNIEL LIVING Lot Size in Sq Ft: 37205 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: _ J5hw TID _.. A " , a v Issued By: ��—T765 Date: Date: Z -f 'b2 MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section �_ _...'% Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 012-242-36 Property owner(s) ROBERT LATTO Mailing address Site address 7655 JEWEL LAKE RD Legal description (Sub'd., Block & Lot) OSMOND OLSEN LOT 3 Day phone Legal description (Township, Range & Section) Lot Size 37205 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) EE (w/wo ADU) Septic Tank El Upgrade Q Duplex ElHolding (D) Tank ❑ Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: S Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. 650:2,31610 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Feb. 10, 2023 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: Tank permit Legal: Osmond Olsen Lot 3 To whom it may concern: This is a request for a septic tank permit on the above referenced lot. A new 1250 gallon plastic tank will be installed. Both cleanouts in the trench will be located and extended. This new tank will not impact any of the surrounding neighbors, see the attached site plan. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231010, Curtis Townsend, 02/21/23 1"=50' PROPERTY LINE EXISTING HOUSE-JEWEL LAKE ROAD-REPLACE EXISTING 1,250 GALLON SEPTIC TANK W/ NEW 1250 PLASTIC TANK DRIVEWAY EXISTING WELL 100' RADIUS OSMOND OLSEN LOT 2 DRIVEWAY OSMOND OLSEN LOT 3 OSMOND OLSEN LOT 4 OSMOND OLSEN LOT 1B OSMOND OLSEN LOT 1A HENNING LOT 1B STRAWBERRYPATCH BLOCK 1, LOT 2 EXISTIN G GARAGEEXISTINGHOUSE WELL PROPERTY LINE SCALE: DJRDRAWN: DATE: OSMOND OLSEN, LOT 3 Anchorage, Alaska ROBERT & VERNIEL LATTO 2/8/2023 CO DCO LOCATE EXISTING CO/MT FOR NEW COSA AWWU WATER SERVICE WELL WELL WELL BOTH LOTS SERVICED W/ ONE WELL LOCATED ON HENNING LOT 1A, WELL LOCATION INSPECTED WITH OWNERS BOTH EXISTING WELLS LOCATED IN THE FIELD BOTH EXISTING WELLS LOCATED IN THE FIELD Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231010, Curtis Townsend, 02/21/23 M � ti OJ U w 03 �� R O- m d c >,c W ca c N a n 0 o Q rno J W "aa)i .c 0_ y n lo' ('3--= c2 p V o Oco U -o Q �I w mCL>flQ c N U)0 wc$m U) rn°J wm�� ao,m Qami c rn� Vtz 6 D£Oo00S �, r m -0 L �, c oa z o� 10 E m Q N CO N D cn C N � -0 =1 m 2 E> Q~ N Ti)ps y 4 Pa4S rn m ESC Q�om0Nr Q �y o W Pip Cc:—ID o rami cwa°�� 0 0 D c m '04n�M aUi `m Es m 0 Ya c ° ° Y O > -� L C O U caN LL W O N a�C a) m U r(Lp �-0mcoo3umi Q yu3o o O — Q r y .C3aa) �m�oo�� os do rnN c o Amok>m�>0E cLiO ErTa _E m rca ��owwmm cco co omao m m Q t€ U o r 'o 0 m" mE ° m m m ° c O m m m c c c m m m n —0 n o t� c°�� r oma° v cmiw a' ov N �'m °1v m Q U U U m m m m 0 m m 4'49 L"3 cnc�vf0a+mm o 3F cLLa Q.E m m mom'>s�y A m y m m ° n V E N U w p C NU- N�—Ol > ✓ m O V (D 0 U I �,N L6L O \ [a 7 > z m m m E'4 V .2 �� 2 E � V) CO 411W —' m o m N Z'Sl ale4dsV % �. I 0, 1 E ° �m am N N CO I O, + �� o �u / -- m 00 � F. o / W 1 ST ' +J o mm oo' p O c d7 ,, N �r �0-2 c E J w ti b. _ •.��0 mwc m m c/) J N w I1 •'slC °mEo o w CLE t U)o m ° C '— U Q c W °.iUL°`mz_E O� t °UO3" 3 — C U9 O m C m m m r,-.2 o m m 45 N m m U m n t17 -0m Ino2`—°m > -0 ao a-6 w m� m m m (O d m m m 0 CL ED O ti (D m N C y r O) m.� C O N t o m ° m N m N CN o m° m aCD m F w (n W C O) m O � Q _mN � W 4 �N =�zp O � tIz �O £0000s 0 Q = w L N 4 GION 99S) uoilisinboy MOH N J z o o= z z O d UF-R:W LO LO II IX0LL T-� O O z co co � LLI F-°0Z� J wNwp cn U Wo�W z£o9s (q w�a� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchora§e, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OFI WELL INSPECTION REPORT NAME MAiLING ADDRESS LEGAL DESCRIPT~©N LOCATION Well DISTANCE TO: PHONE 2 0 Lq¢ ~-f ~ ¢~-21 VI. SI fha Absorption ~rea ' Dwell~nq ~0 / Material~ ¢)/ Inside length W dth DISTANCE TO: J~LN EW [] UPGRADE Foundation Material Tre"e' Th NO. OF BEDROOMS PERMIT N O."- g2 0oo t No. of com~f.~artments Liquid depth IF HOMEMADE: Well Dwelling PERMIT NO. Manufacturer Liquid capacity in gallons DISTANCE TO: Total length of lioes Material benaath tile Depth inches No. of lines We,,.. t 6 0 Lengtb of eac~ line 70- PERMIT NO. ~;.1 OeO [ Distance between lines Total effec~tiva absorption area PERMIT NO. Top of tile to,finch grade Length Width Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO, DISTANCE TO: Building foundation Sewer Une Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER ]?lq - -~T/tT E, R [-'_MAR KS Sa,FT./ / APPROVED DATE LEGAL 72-013 (Rev. 3/78) PEF.:M I '[' i',tO. FIPPLIC:FINT ROBEF.':T G LFITTC~ L 0 C F:I T 10 N LEGFtL L. 2.": OSMOND OI._SON iS,."[:, :3480 ATKINS F'L.F~I?:E:i FII'.gCHCIRflGE S~9 .7..':44.-:1..7'0:~: LCIT 'S.;IZE S~S,L':.','.~?.'.~.~ SQtJI::II:~:E FEET TYPE OF SOIL.. FIBS;OF::F'TIOI'.,I SYSTEM IS: 'TI;.:ENCH MFIXIMIJI','t I'.,IUMBER OF' BEE:,F.:OOMS = 4 SOIL RFITING ,::SL.':! FT,.-"BR::,= TFIE F.:EL::IUIF::E:D :SIZE OF THEE 'S.;OIL FIBSORP"I'ION S"r'STEFI IS: IE::. E F' T' II--{ == i z-~: L_ E." ~"-.~ C~ '1- H = Z: L=.". ,.Z-~ F.~." Ifz:w %." E7.-27 L. ID IE P' -r IH == THE L.E'NGTH DIMENSION IS THE LENGTH ,'IN FEET::, OF' 'T'HE TI:;.'.ENCH 1.71F.: DRFJII',IFZEI...D. THE DEPTH OF la TRENCH OR PIT IS THE DZSTFINC:E E:ETP.IEEI'-,t TIqE SUF.:FFIE:E: Cfi:' 'THE GF.'.OUND FINE:, THE BOTTK~M OF THE EXC:FI'v'RTION ,::IN F:EET::,. 't"H['.;.'I~:E IS NO SET !.,.I:[DTH FOR TRENCHES. THE GF..'FIVEL E:,EF'TH IS TI--IE MINIMIJM DEF'TH OF GF..'RVEL BETI.,.IEEN THE OLITFFIL. L F'IF'E FiND THE BOTTOM OF THE': E;:'.','C:FI'v'FITICd'.,I ,:.'IN FEE:T:). PERM I'1" AF'F.'I... t CANT FIFIS "FHE RE:SF'ONS I B I L I T'¢ TO I NFOF.'.i'd TFI I S ['.:,EF'IaF. rTMEI'qT DUI:;: I i'.JG "f'HE II'.,tSTFILLFITION II'.,ISF'EC:TIONS OF FIi',IY I.,IELLS RE:,.:rFtC:ENT TO THIS; F'r4'.OF'EF.:TY FiND "['FIE NIJMBEF.: OF RESIDENCES '['HAT '['HE P.IELL t,.IILL SERVE. ........ T' ti....ii ,:Z, ,:: 2 ::, Z b.,q :S F" EE C: T 1: i::., ~-.II :5 FII F-': E ~'~: F': ¢;., Lb T..F..: E IL'::: ................. BFIf":I<:FZLLING OF 171NY SYS'r'EM 14ITHOUT I:::.IIqRL INSPEF:TION FiI',ID FIF'F'F~:O',,,'FiL E~"r' THIS [:'EF'RF.:Tt"IEI'4T 1411_1_ BE SIJB3'ECT TO PROSECUTION. MINII'"IUI"i DISTFINCE BETP.IEEN FI I,.IEL.L.. FINE:' IRl",l"r' OI"4'"SITE SE:I.qAGE E:'ISPOSf'"IL. SYSTEM IS ::LOCi F:'EET F'OR fl F'F.:I',,,'FITE P1EI_L OF.: :;L50 TO 20El FEET FROM FI F'UBLIC 1.4ELL. E:'EF'E:IqDIiqC'i UPON THE:: TYF'E OF F'UBL. IC !.,.IELL MII',IIMUM E:'.ISTRNC:E FROM IR F'P::IVFITE !.,.IELL TO FI F'RI',,"RTE SEI4EFi: LINE IS 25 FEE'[' ANE:' TO FI COI'"IMUNITY SEI.,.IER LINE IS 7.5 FEET. I.,.IELL LOGS FIRE F.:EC~UIRF[::, F:INE:' I'"IIJST BE RE'['URNED TO -['HIE E:,EF'FIFUr'MEblT 1.4ITHII'.,I :~:e~ DI:qYS OF THE P.IEL. L C:OI"IF'LETION. OTHEF.: REg!UIREMENTS MFI"r' flF'PI._Y. SF'EC:IFICFI'rlONS fiND CONSTF;:IJC:TICIN DIflC:iRRI'dS FtF.:E FWFI I I._FIBLE TO I NSUF.:E F'F:':CIF'ER I I',ISTALLlaT I ON. 1.' C:EF.:TI FrY THFIT :~.: I Fff,'l F't.RM:[L. IFIF.: P.IITH THE F.:EC..!UIF.:EFIENTS FOR ON-SITE S[.:.'I-,IEI;;'.S FINE.', P.IELLS FrS SET FORTFI B'~" THE MUNICIF'flLITY OF FINCHOF::RGE. 2: ]: !.,.tIL. L. INSTFiLL THE SYS'FEM IN I-RCCOF..'E:,RNCE P.IITH THE C:ODEES. E:: I UNDEF.'.STFIN[) THFiT THE ON--.SITE SEI,.IER SYSTEM i',IFIY IRE6!UIRE E:NL. FIF..'E-[EhlENT IF:' TNE RESIE:,ENC:E ;ES t~:EI'"IODELED TO INCLUDE I','IORE THFlt'-,I 4 BEDF.:OOMS. FIPF'L I C:Ftt'.4T F.:OBEF1:T G LFITTO SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTIVIENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST PERCOLATION TEST SLOPE DATE PERFORMED:_~'-2 10 11 "~---I 2 13 WAS GROUND WATER /YA/0 S ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? 14- 16 17 18 19 Gross Net Depth to Net Reading Date Time Time Water Drop 20 COMMENTS PERFORMED BY: ,p/~) /~(..~ PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN - FT AND F/T DATE: 72-008 ~6/791 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 012-242-36 Legal description OSMOND OLSEN LT Site address 7655 Jewel Lake Rd Current property owner(s) Robert Latto 3 Expiration Date: 3 Z X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: -41- This x This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory x Other COSA ApprovaLJune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department t.__ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 012-242-36 Complete legal description Location (site address) OSMOND OLSEN LOT 3 7655 JEWEL LAKE RD, ANCH AK Current property owner(s) ROBERT LATTO 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑t Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑■ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 55-0 Date of Payment .212YX23 COSA# 3sc23/6g3 r Cf 2W:37(0 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 Arsenic Advisory Certificate of On -Site Systems Approval # OSC231043 Subdivision: Osmond Olsen, Block: , Lot: 3 A water sample revealed an arsenic concentration of 28.4 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. COSA Checklist Legal Description: OSMOND OLSEN LT 3 ParcellD: 012-242-36 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4/6/83 Total depth 319 ft Cased to 319 ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 2/7/23 Static water level at beginning of test 86 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 58 Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/4/83 0 ALL standpipes present per record drawing Total measured depth from grade 8.5 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A —pressurized field. ❑ Per record drawings, field is insulated. fi❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date COSA Checklist—June 2022 Well production at time of test 4+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑Q No N Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 28.4 ug/L ❑ Arsenic less than MRL (ND) Collected by Date 2/7/23 MNA C. LIFT STATION ❑ Required maintenance completed Age of lift station _years Lift station material Comments: Adequacy test date 2/7/23 Results Q Pass Fluid depth prior to test 0 in Water added 600 gal Newfluiddepth 0 in Elapsed time 1330 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 54 in Effective depth used 0 in Effective depth remaining 54 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' Q Yes if No _ ft QQ Yes if No _ It Neighboring Tank > 100' Q Yes if No _ ft Absorption Field on Lot > 100' E Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100' DYes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No _ ft Mi Yes if No—ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑E Yes if No _ ft [i Yes if No _ ft ❑ N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑0 Yes if No ft Surface Water > 100' F!] Yes if No _ ft Tank to Property Line > 5 Field to Property Line > 10' Water Main > 10' ro-1 Yes if No _ ft ❑E Yes if No _ ft ❑0 Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' a' Yes if No _ ft 9 Yes if No _ ft Water Service Line > 10' Yes if No _ ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS BOTH OLD CO/MT FOUND AND SHOWN ON ASBUILT G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm N(I'r`tc 1` L8 ee AVIA `r E Phone 727-8864 Engineer's Printed Name kl� • Date 2 2 ... <' f ... . r,... r4 MICHAEL N AXC RSC;V r' COSA Checklist June 2022 unicipalitYof Anchor ¢ POUCH 6-650 ANCHORAGE, ALASKA99502-0650 (907) 264-4111 TONY KNOWLES. MA YOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION <Permit ~: 821029 .January 31, 1983 TO: Permit Applicant Subject: ]lot 30smond Olson Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerel~ Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/Ljw enc: Copy of Permit SWP/057 PERMIT NO. 025 "L" STREET, RNCHORRQE., RK. 264-,472'0 I..-! [:-"Z i1_ I .... F" IE E'.: I1--'t Z '"!T" < L=:2i0;29 > RF'F'I_ I CRNT LOCRT I ON L. EGRI_ ROBERT G LRT'TC~ LZ.': OSMOND OLSON 8480 RTKINS PLlaCE LOT E;IZE 999999 SQLIRRE F'EE.[' MINIMUM DISTANCE BETHEEN la HELL FIND FINY ON--SITE SEI.4RGE I>ISF:'OSFII.~ S'T'STEM IS :t00 FEET FOR FI PF.:I',,,'laTE HELL OR '150 TO 200 FEE'[' FROM la PUBL]:C HELL DEPEN[:,:[NG UPON THE T't'F'E ElF PUBLIC HELL MINIMUM [:,IS.['FtNE:E FROM R F'F.:IVRTE HELL TO FI PRI'v'RTE SEHER LTNE IX 25 FEET RNE:, 'TO FI COMMUNIT'¢ SEIJEF.'. LINE IX 7'5 FEET. HELL LOGS RRE REIP..UZRE[:, laNE., MUST BE RETURNED TO THE DEPRRTP1ENT 1.4ITHIN 30 OF THE 14ELL COMPLETION. OTHER REI_.]!UZREMENTS MR"r' RPPL"r'. SPECIFICRTIONE; I=IND CONSTRUCTION [:'IFtGF.:laMS taRE[ R',,,'RILRBI_E TO INSUF.'.E: PROF'ER INSTRLLRTtON. F=" E F~ 1'4 ][ T E-] :='="- F" ][ R E: E; I[::' E L~-.- E I~'1 b:3, E I;-': 2-": ~-1_., :J- 1-:]'" ~,E,: 2-E: I CERTIF'¢ THFIT i: I RM FRMILIFIR H:[TH THE RE6!UIREMENTS FOR ON-SITE SEHERS RND HELLS FtS SET FORTH B't' THE I"IUNICIF'laLIT'¢ OF RNC:HORRCiE. 2: I HILL. INSTRLL THE S'¢STEM IN RCCOR[:'RNC:E HITH THE CODES. RF'F'LICFff.,IT ROE:ERT G LFITTO ,./- ., ..: V4. 0 (907) 243-2282 KEN JOHNSON COI IPANY WATER WELL DRILLING PUMP SALES & SERVICE 30 YEARS ALASKA DRILLING 3163 LINDEN DRIVE ANCHORAGE, ALASKA 99502 Robert G. Latto ( 344-1702 ) Anchorage, Alaska REI Lot. 30smaond 01son Sub. Div, 0 ft to i ft Ift to 7 ft 7 ft to 9 ft 9 ft to 65 ft 65 £t to 79 ft. 79 ft to 105 ft 105 ft to 140 ft 140 ft to 147 ft 147 ft to 158 f~ 158 ft to 166 ft 166 ft to 170 ft 170 ft 'to 182 ft April 6, 1983 J',.~U,~qiCIPALI'W OF ANCI-IORAG)B DL-PT. OF HEALTH ENVIRONMEN'rAL PRO'rECTIOI~ WATER WELL LOG RECEiV !D Frozen silt Brown sand Same with black organics Sand and bro~n silt Sand & gray silt ( weeps H2 0 ) Heaving sand ( 10' to 20' ) Clay Same but weeps H20 50' head Clay with trsce fine gray. weeps.. Clay with fine sand seams.,weeps 100' static,. Fine sand Heaving fine sand ( 12' ) 182 ft to 193 ft Heaving fine silty sand ( 40' ) 193 ft to 197 ft Very dirty water bearing l~ed. sand and grav. $5' head..test bailed ~ 15 gpm ..40 Drawdown. very dirty..gritty..sladge..clay ~exture.. 197 ft to 201 ft heaving sand ..very dirty.. 201 to 220 ft Same..heaves 40 ft. 220 to 225 ft Clay 225 ft to 226 ft Med. gray and sand.,water bearing.. Test pumped but unable to claar up..vez, yd~.r~y ~ ' · ' 226 ft to 234 ft Med. gray and gray silt .,water be~;ing.. Same as test pumped..No good.. 234 ft to 235 ft Glacial till ..dry ... 235 ft to 246 ft Fine gr~vo & sand wa~er bearing. Dirty..no ~ood. 246 ft to 251 ft Tight fine gray. and silt.,casing tight., 251 ft to 256 ft ~ed. gray. and gray silt ...dry.. 256 ftc 260 ft S~e with clay texture 260 ft to 270 ft Clay & mod, grav. Drls. open ( dry ) 270 ft to 280 ft Same but weeps H20 280 ft to 282 ft Over night heave 20' silty sand 282 ft to 286 ft ~ed. grav,& clay 286 ft to 305 ft Plastic clay & pea gravo 305 ft to310 ft Ned. grav.& gray silt 310 ft to 319 ft Large boulder at 310,.bent casing., drill to 319' and hi~ water zone.. Drop in 21' 7"..5 in. liner with K-Packer See test pump data..,. 243-2282 JOHNSON COMPANY WATER WELL DRILLING PUMP SALES & SERVICE 30 YEARS ALASKA DRILLING 3163 LINDEN DRIVE ANCHORAGE, ALASKA 99502 APRIL 6,1983 Bob Latto Anchorage, Alaska REt I,o~ 30smond 81son Sub. Div. Je~vel Lake & Strawberry Rds. TEST PU~4P_. DEPTH 319 ft. water level 80 ft, l~onday April 4, 1983 T I~IE DRAWDOWN GPM 12o5 6 12[o 5 ~215 [.lo 5 1330 126-3 5 lh,2o 13o 5 1605 132-9 5 19~+5 139-~ 5+ Continue pumping overnight April 5, 1983 Tues. 0735 136,.7 5 1110 136-5 5 1700 :[36-4 5 Continue pumping o~er night April 6~ 1983 Wednes 0830 136-4 5 ;,'~tJNiC p;.ilTY OF ANCHOI%&G~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECT[O~ RECEIVED REI;JARKS Very dirty dirty but clearing Cloudy with fine sand cle~%,very light cloudy clearing ( same ) clearing. Clean and clear.. Took water sample and shut off pump. APPU 5, NT Property .,Owner i. Mailing AJdress ! (-"-' '.;-) ,--) ·~, ; ,..'~ f / ,:, t\,:z ~ Buyer Address FILLS OUT UPPER Ht u ONLY ~-, 17,:. ) '~' r'/' Zip Code ~' ~' :~ Zip (;ode Phone Lending Institution Realty Co. & Agent Address Zip (3ode Zip Code Phone Phono Legal Description ('~'_') ~:~ [ ',,'/(...) ? ) C/ (/~5 / Street Locati~ "Z¢;,'~'" 5' Type of Residence ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other ~2 ~/ater Supply F~ Individual ATTACH WELL LOG. A well log is required for all wells drifled since June 1975. [] Community For wells drilled prior to lhat date, give well depth (attach log if available). t~ Public Utility Sewer Disposal f:3 Individual Year Individual Installed: i / ',~ ;L [] Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Inspector Inspector lespector Dale Inspector Field Notes: MUNICIPALITY OF ANCHORAGE DEPT. OF H%"LTil ENVIRONMENTAL .RECEIVED ) DISAPPROVED ) CONDITIONAL APPROVAL' DATE ~/,:{'__gS' M' o~ -~ 'CONDITIONS OF APPROVAL Soils Raling Date Sewer Installed Well To Absorption Area /<gdt _~. Well to Tank / ~tZ~g ' 1- Well Log Received Septic Tank Size 72.023 {3t82) 243-2282 (EN JOHNSON COMPANY WATER WELL. DRILLING PUMP SALES & SERVICE 30 YEARS ALASKA DRILLING 3163 LINDEN DRIVE ANCHORAGE, ALASKA 99502 April 6, 1983 Robe~:'t Go ~T.,atto ( 34'4'~'1-702 ) Anchorage, Alaska Lot .50sm ond Olson Sub. Divo WATER WEI,L LOG O J't to J .FL 1 f t 'to ? ft ? f t to 9 ft ? ft to 6~ ft 55 ft -to 79 79 ft to 105 ft 140 ft to 147 ft 147 f t 'to ltl8 ft 1~8 ft to 1~8 ft 166 i% to l?O 170 ft to 182 MUNICIPALITY OF ANcHoRAGE DEPT. OF ENVIRONM!~IAL pp,.oi~CflON t,'ro zen silt Brown sand Same with black organics Sand and brown silt Sand & gray silt ( weeps H2 0 ) Heaving sand ( 10' to 20' ) Clay Same but weeps H20 50' head Clay with 'trace fine grav. weeps.° Clay with fine sand seams,.weeps 100' static,o Pine sand Heaving fh~e sand ( 12' ) 182 ft 'to 193 ft Heaving fine silty sand ( ¥0' ) 193 ft -to 192 ft Very dirty water bearing Ivied. sand and ~{ravo ?5' head., test bailed e 15 gpm 0o~0 Drawdown. very d~:rty..gritty..sludge''clay texture,~ 197 ft 'to 201 ft heaving sand 0.very dirty. 201 'to 220 f't Same..heaves ~0 fto 220 to 22_5 ft Clay 225 ft to 226 ft NIed. gray and sand..water bearing,. Test pumped but unable to claar up.,verydirty 226 ft to 23¥ ft lvled, grav and gray silt ..water bearing.. Same as test pumped~.No good.° 23z~ ft -to 235 ft Glacial. till ..dry 235 ft -to 2L~6 ft Fine Crav. & sand water bearing~ Dirty..no good. 2].~6 ft -to 251 ft 'f.:'L~ht fine grav. and silt..casing ti~hto. 251 ft -to 256 ft Med. {~rav. and gray silt ...dry,, 256 fto 260 ft Same with clay texture 250 ft to 2?0 ft Clay &med, gray. Drls, open ( dry ) 270 fL to 280 ft Same but weeps H20 250 ft to 282 ft Over night heave 20' silty sand 282 ft -to 286 ft ifledo gravo & clay 286 ft to 305 ft Plastic clay & nea gray0 305 £t to310 ft lVledo gray. & gray silt }lO i't to 319 ft Large boulder a~,,310.~bent oasing, o drill to 31.9' and hit water zone.. Drop in 21' ..~ ino liner with K-Packer See test pump data October 31, !933 ¥?C.V ;[ (}'d,