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Home My WebLink AboutHIDEAWAY LAKE BLK 1 LT 4AHideaway Lake Block 1 Lot 4A #015-471-08 nc Municipality of Anchorage .� ; . Development Services Department Building Safety Division `• •' On-Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 Page ► of 3 www.d.anchorage.ak.us (907)343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. 5 w o00 v PID Number. o f S- Y71 -O N� 5f+c leen P. l-ar Icm Wastewater System: ❑ New ® Upgrade Ada*ta11000 Ntdaawa Gold Dr. 9-7-5-1tir ABSORPTION FIELD plan.3 Y _ f'(3 �/ N""°•• a B•drttn'• At 61 D••p Turn t3 Snrw. Tra.rn 0 Bed O Mtud O o0w. Sod Rawq Taal Daps can "M Grady: LEGAL DESCRIPTION a 1. o p ir 12. s' Ft. altar. la. aW6waarc Depth b Poe Gtnam atm apnr pada: Ca* dean 4rrael PW: yA ►111C1t QGC/4 %.fk 2•S FI. 10.6 FI. TOWWW Rary•: Sactian: Fa6ddad1et.y WWd pada: Gra.w Lwpdc 6o o.S FI. Fl. Gmranan: Nu aMMt: attar. E•n.•an MMt: Well: Ext S T ❑ New ❑ Upgrade 2.S FI. 1 - FL cw.sdr (PM00. A S. ck Tdr D-M CU"W. Tar sbw p•te New IZoo Fla Pa Iftt". y 1. o sd i' 1.15'"— S_c4y;NC+ I✓C Ft. h Dry.. D" Dmad 5unc Wrr L• Y,.raa.r [� CeArl't E%CAVO Fln ON* kwa : 10/2-3/00 FI YMd Para sr a Catna wyry Alt.• Grand: TANK GPM FL FL SEPARATION DISTANCES ❑ Septic ❑ Holding 19 S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PublidPnvat Line L'r"d°m"` An cAoll-1' t %An:t CaWary: ISOd Gr. Frain Tank Field Station Tank Sewer Mranr: SI(-eel Nu Of GanprlrM $ Z Wm Iypl 2a-o' 1K0' - >Z•t' LIFT STATION s.Aaca wrr ►O'-1' 7100' IUy` — LV L" (,r' 11' GS' —Zn Sao. FY raj cr Mwlyduar A4nchora T nk l ortnco 'Pump M• M K 'Pump aY Mvr M: 119n.1. 0.r'. Ftvdran Ss ` ISS' SS' — Al 21 aL •1 h ly n Pump Mak. a MOM EMM"htl) a P ft er Cwm N" — _ — — OSI Va. ho M. O.h. Rymrka BENCH MARK QF`. .n41 rta 11 Cx lj Qn fl4wi Lwwn aro a.awtm: /iucle f/.n C-11CreAC Slet S 42ecr a ,. mOVIn di I e.m .n NwnW EMvaw,. wo4eVC IIGi 1rn I"14/—ac Ft n(/er t4&VM M.A. x Engineets Stamp [n Cil Ill ht, aroi c l-e I ran a -, GIS .r%'Fw+ ®e'IAE'!QR'QO .et--i9 ........ = : 'L ar-L FlaNr„P Tech Suc Dates: 1 �a "-'•�';' Inspections performed by: �`TR / �— :l.......:..............:. 2"d Development Services Department Approvals-��•.••••.• N Date: '�.1' D / '. Ce. ,L_� -.v' Reviewed and approved by: PERMIT NO: SW000442 PID NO: 015-471-08 FSO SWING TIES: FROM: TO: S.T. C.O."C" L.S. M.H. "D'• TR. M.T. "E" TR. M.T. "F" LOT 4A, BLK.1 HIDEAWAY LAKE SID PAGE 2 OF 3 COR. "A" COR. "B" 61' 89.5' 67' 100' 172' 196' 157' 199' fRm 3E ,, ' 4" DIA li. , , r D-3034 , -� M.T. y� LIFT STN. 1.25" DIA SCHED. 40 PVC CONTROL',, C. PANEL } "D•• 60' LONG SOIL ABS. TRENCH % i `TBM ' O,p W.10.0' GVL BELOW PIPE f % ARAGE ' ., 2 „ 1500 GALLON STEP TANK % T.H. PAVED #1 L� TENNIS % COURT M.T. "F" y �^ C)T' ............ ;. • A} r; + Permit Number: SW000442 MUNICIPALITY OF ANCHORAGE Department of Health and Human Se...--- On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 3434744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Legal Description: HIDEAWAY LAKE BLK 1 LT 4A Design Engineer: 0019 Flattop Technical Services Owner Name: Stephen P. Leske Owner Address: 11000 Hideaway Lake Dr. Anchorage . AK 99516 - Lno cc�.6-7`% io%�vll� Vio" Date Issued: Oct 19, 2000 Expiration Date: Oct 19, 2001 Parcel ID: 015-471-08 Site Address: 011000 HIDEAWAY LAKE DR Lot Size: 46129 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑.7 Disposal Field ❑v Septic Tank E] Holding Tank ❑ Privy El Private Well ❑ 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: /6 — H _ 00 FLATTOP ��TE Y �� i .,, a� � C�HNIGAL SER C�S'�_ Cn'n. & ENVa ON'.MENTAL ENGLNEERLNG • ENERGY CONSERVATION & A.NALYS6 THEODORE F. MOORE, P.E. 14530 ECHO ST. Pit: (907) 345.1355 ANCHORAGE, ALASKA 99516 October 13, 2000 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 4A, Block 1, Hideaway Lake S/D located at 11,000 Hideaway Lake Drive. The present system is no longer able to accept the wastewater load generated in the residence. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed soil absorption system will be constructed in the vicinity of test hole 9 1. As can be seen from the soil log, the native material between 3' and 8' below ground level has a measured perc rate of 6 —10 minutes per inch and the sand below 8 feet has a measured perc rate of 2 minutes per inch. The proposed trench has an effective gravel depth of 10 feet, extending from 3 to 13 feet below ground level. Of this, the upper 5 feet is designed using a soil application rate of 0.8-gpd/sq. ft. and the lower 5 feet is designed using 1.2-gpd/sq. ft. as specified in the wastewater ordinance. Thus, the total allowable application rate is 20 gpd per lineal foot of trench. A 4 -bedroom residence having a design wastewater flow of 600 gallons per day would require a minimum of 30 feet of trench at 20 gpd/ft of trench. The proposed 40 -foot long trench design is conservatively sized to handle 800 gallons per day. The topography of the lot in the area of proposed trench slopes downwards towards the west at 17%. The proposed project will have no adverse impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space - surface and subsurface, or on drainage. The project will have the beneficial impact of eliminating an existing encroachment by the present soil absorption trench on Lot 4A on the 100' protective radius around the well on Lot 5A. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. IDEAWAY LAKE LOT 5A BLOCK 1 ,HOUSE ry SEPTIC AREA , , , THEODORE F. MOORE ,• CE .3539 ,yj 'V t. ROCK - PAVED', TENNIS COURT Mvi441 LOT: BLOCK SEPTIC AREA „ INSTALL NEW 1500 GALLON STEP TANK 14 � I CONSTRUCT40'LONC - "SOIL ABS. TRENCH _ W. 10' GVL. BETWEEN 3.0' AND 13.0' B.G.L. T.H. C�, /�, 1.25"PVC ; 1N$, 4DERDRIV ABANDON. EXISTING SEPTIC TANKS AND SOIL ABS. TRENCH LOT 4A, BLK. 7 , 1, I. 1� , 1; i; / ZLOT HIDEAWAY LAKE SID' /� BLK.2 , WELL t� /.% ct, LOT 7, BLK. 2 / LOT 4A, BILK. 1,HIDEAWAY LAKE SID SEPTIC SYSTEM UPGRADE SITE PLAN i I 1 I , � I CONSTRUCT40'LONC - "SOIL ABS. TRENCH _ W. 10' GVL. BETWEEN 3.0' AND 13.0' B.G.L. T.H. C�, /�, 1.25"PVC ; 1N$, 4DERDRIV ABANDON. EXISTING SEPTIC TANKS AND SOIL ABS. TRENCH LOT 4A, BLK. 7 , 1, I. 1� , 1; i; / ZLOT HIDEAWAY LAKE SID' /� BLK.2 , WELL t� /.% ct, LOT 7, BLK. 2 / LOT 4A, BILK. 1,HIDEAWAY LAKE SID SEPTIC SYSTEM UPGRADE SITE PLAN co 1.25" DIA SCHED. 40 PVC. W. `. 4" DIA 40 D-3034 HOLES IN BOTTOM SPACED 244"" O.C.O. FROM FDN. C.O. ----------------------- 1 M.T.J 40' LONG SOIL ABS. TRENCH M.T. W. 10' GVL. BETW 3' 813' B.G.L. m 1 V) d o 1500 GALLON STEP TANK SECTION "A - All SCALE: 1" = 5' 1.25" SCHED. 40 PLAN VIEW SCALE: 1" =10' TUBE MOUND BACKFILL 6" ORIGINAL GROUND FILTER FABRIC 1.25" SCHED. 40 PVC W. 3/16" HOLES @ 24- 1 /Z* 4" 1/2" - 2 1/7SEWER GRAVEL BOTTOM OF EXCAVATION A�,•accaQq` OF X15 .............7.....'.... u CODOhe F. MOORE . % CF -3589 - -,�A' LOT 4A, BLOCK 1, HIDEAWAY LAKE S/D SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECIMCAL SERVICES SCALE: AS SIIOWN 14530 ECHO STREET DRAWN BY: TFM ANCI IORAGE, AK, 99516 OCTOBER, 2000 rTfattop Technical Services 14530 Echo Street, }anchorage, JIX 99516 Thone (907) 345-1355 Lot 4A, Block 1, Hideaway Lake S/D 11000 Hideaway Lake Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of abandoning two existing septic tanks and installing anew 1500 -gallon STEP tank which discharges effluent into a 40 -foot long soil absorption trench containing 10 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. The contractor shall arrange for a surveyor to accurately locate the portion of the east property line fronting on Hideaway Lake Drive in the vicinity of the proposed trench. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as reinstalling pavement and/or placement of topsoil and reseeding areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tanks are not to be retained in service and therefore must be properly abandoned by thoroughly pumping, removing the tops and backfilling with soil. The existing soil absorption trench is to be abandoned in place with the standpipes removed. 2.2 The new 1500 gallon, 2 compartment STEP tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. The bank shall be constructed to withstand a burial depth of approximately 7 feet. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot and shall be insulated with a minimum of 2 inches of rigid foam for a width of 2 feet. A cleanout shall be installed within 1 - 4 feet of the building foundation. 3.0 Lift station: 3.1 The lift station shall be installed in the second compartment of the STEP tank which has an additional 250 gallon capacity. The lift station package shall be an "Orenco" system as supplied by Anchorage Tank. 3.2 The contractor shall be responsible to obtain the necessary Municipal electric permit and inspection, and shall provide a copy of the electrical inspector's report to the engineer overseeing the construction of the wastewater disposal system. 3.3 The lift station shall be equipped with a watertight, insulated manhole riser and cover extending a minimum of 6" above final grade with positive surface drainage away from the manhole. The contractor shall be responsible for determining the necessary length of the manhole riser. 3.4 The on, off, and alarm floats shall be set at the elevations specified by the lift station supplier, and their proper operations shall be verified by the contractor. 3.5 The discharge line from the lift station to the soil absorption system shall be 1.25" dia. Sched 40 PVC. It shall be buried a minimum of 3 feet below ground level and the portion of the line that passes under the driveway shall be insulated with 4 inches of rigid foam insulation. 4.0 Soil absorption system: 4.1 The soil absorption system shall be constructed by excavating a 40 -foot long trench to a depth of 13 feet below original ground elevation in the vicinity of the trench. The alignment of the trench shall parallel an existing contour of the land and care shall be taken not to encroach on the 10 -foot utility easement adjacent to the Hideaway Lake Drive R.O.W. 4.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 4.3 A total of 10.3 feet of approved sewer gravel shall be placed in the bottom of the excavation with the 1.25" dia. Sched. 40 PVC perforated distribution pipe laid level such that the pipe invert is no less than 10.0 feet above the bottom of the sewer gravel. The distribution pipe shall have 3/16" dia. holes drilled in its bottom spaced 24 inches apart. All pipe connections in the distribution system shall be glued, and the ends of all pipes capped. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the 9200 sieve. 4.4 Monitor tubes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 4.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 4.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 4.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 5.0 Inspections: 5.1 A minimum of4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the STEP tank, but prior to placement of filter fabric, and (4) after rough backfill and grading is complete. The STEP tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # I SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 4A Block 1. Hideaway Lake S/D DATE PERFORMED: October 4 2000 PERFORMED FOR: Steve and Karen Lesko DEPTH Pf SLOPE 11 12 13 14 SH COMMENTS: Depth to Groundwater Date _o groundwater (feet) •ia• u:-�1�: 111/0 1 I kluiE ttt,it .. I 1 iiai i�::=ki i;: k�lr;i;•i SM/GM fill with buried logs 2 Add water 8 start t: Pt Original ground level 3- TFN.S #1 4— SM Reddish sandy loam --Tdd water #2 4:440 4:4920 5 Iija:[{%Illi 25/8 6— •%13iLi11�1:11 23 18 ti I M11U{ya! SM/GM Gravely, somewhat silty sand 4:54:40 5 2013/16 7 lt,•.'•liii3ii e�i?I:�1� iuin' B SP/SM Gravely, slighty silty sand 9 Scattered lenses of MUSM and SP/GP 11 12 13 14 SH COMMENTS: Depth to Groundwater Date _o groundwater 10/4/00 Monitorlubed 111/0 :.`W Ed1Y I kluiE ttt,it .. I 1 rS; iIEODC!:E F. n:00RE sc,,.•.• CE -35E9 " SITE PLAN 17% J N Date Reading Clock Time Net Time (minutes) Percometer Reading ...:fLSTNY. 10/4 soak :.`W Ed1Y I kluiE ttt,it .. I 1 Add water 8 start 4:39 nvFo T.H. 235116 TFN.S #1 4:44 20171 6- --Tdd water #2 4:440 4:4920 5 23 T/8 203/4 25/8 Add water i boy 23 18 17% J N Date Reading Clock Time Net Time (minutes) Percometer Reading Net Drop (inches) 10/4 soak FTAND 11.0 FT Add water 8 start 4:39 235116 #1 4:44 20171 6- --Tdd water #2 4:440 4:4920 5 23 T/8 203/4 25/8 Add water 4:49:40 23 18 #3 4:54:40 5 2013/16 213/16 PERCOLATION RATE 2 (minutes/Inch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 10.5 FTAND 11.0 FT PERFORMED BY FLATTOP TECHNICAL SERVICES. I -r`"�`+-�c CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10 /).? /00 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # la SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 4A. Block 1, Hideaway Lake SID DATE PERFORMED: October 2000 PERFORMED FOR: Steve and Karen Lesko DEPTIMI-i�ifll:ffll: Pt SLOPE (feet) SM/GM fill with buried logs 3 4 5 6 7 8 9 11 14 Pt Original ground level SM Reddish sandy loam SM/GM Gravely, somewhat silty sand SP/SM Gravelly, slightly silty sand Scattered lenses of ML/SM and SP/GP 16 19 BH Depth to GroundwaterEDateNM Clock Time ogroundwater Percometer Reading onitortubed 10/5-12'Resoak f W!f %, ".,.'- Y, .� {^ . THEODO^z V O:OORE ; C • C'-353? v SITE PLAN Date Reading Clock Time 795 Percometer Reading Net Drop (Inches) 10/4 17' Presoak 10/5-12'Resoak f W!f I 4:29 27 all 4:.4920 24_/4 / IF,NiJ 4:49:0 T.H. 271/8 FM. #2 Add wa er 5:09:30 5:10 20 25 271 161 # 5:30 20 1 251/8 21/8 At Date Reading Clock Time Net Time (minutes) Percometer Reading Net Drop (Inches) 10/4 17' Presoak 10/5-12'Resoak Add water # start 4:29 27 all 4:.4920 24_/4 / water 4:49:0 271/8 #2 Add wa er 5:09:30 5:10 20 25 271 21/8 #3 5:30 20 1 251/8 21/8 20 PERCOLATION RATE 10 (minutes/Inch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 6.0 FTAND 6.5 FT COMMENTS: 2nd pert test conducted to measure permeability between 5 and 8 feet PERFORMED BY FLATTOP TECHNICAL SERVICES. 1_7s'•'cri++.L CERTIFYTHATTHIS TESTWAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: l0/t,j/0d FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # lb SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 4A Block 1 Hideaway Lake SID DATE PERFORMED: October 4, 2000 PERFORMED FOR: Steve and Karen Lesko SLOPE DEPTH Cock Time Pf (feet) •,i!:;rii isl 10/5 17'Presoak Add water 8 start #1-- SM/GM All with buried logs 20 3 /8 193/8 4 2 •iliir!II 1: 20 —23-1/2 1913/16 11/1 Ad_d_water #3 5:11 1 20 Pt Original ground level 3- 4- SM Reddish sandy loam 6 SM/GM Gravely, somewhat silty sand :.:i!!`•;i iii 7 iEil �i�lalj SP/SM Gravely, slightly silty sand 9 cn�Rsrd lu,•eae of MI ISM anef SP/GP 10- 11 12- 3 BH All W • TIiEOCCS'_ F. L'OORE .• (^ /.` Cr 3539 ti SITE PLAN epMii�z 19$ f>u5, •EVEpI•Y'a. I 9OUlE I I+>•Wo T.H. # r � �o Date Reading Cock Time Net Time (minutes) Percometer Reading Net Drop (inches) 10/5 17'Presoak Add water 8 start #1-- 4:30 4:50 20 3 /8 193/8 4 dd water #2 4:50: 5:10:30 20 —23-1/2 1913/16 11/1 Ad_d_water #3 5:11 1 20 235/8 �uPERCOLATION RATE 6 (minutes/inch) PERC HOLE DIAMETER V. TEST RUN BETWEEN 4.5 FTAND 5.0 FT COMMENTS: 3rd vert test conducted to measure permeability soils between 3 and 5 feet PERFORMED BY FLATTOP TECHNICAL SERVICES. I T� 2k4—'.' _CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: CO / 13 I U o MUNICIPALITY OF ANCHORAGE MEMORANDUM Date Oct 26 To:Whom It May Concern From: D. Roth, Civil Enqineer Re:Waiver Requirement Lot 4A Block 1 Hideaway Lake Subdivision must have a waiver prior or during the course of a Health Authority Approval. 49 88 Do not process any Health Authority unless the system has been upgraded and meets all required distance (horizontal) separation distances or; has the required waiver request and approval from this department. 91-015 (Rev. 1/81) Signed "~-A M E MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~ N~.- J'~,~.~ ~'~'~//v~-~. ..~,~'-. ~ ~PGRADE MAILING ADDRESS Manj./factu ret ; y~);,ga OhS IF HOMEMADE: D STANCE TO: Well~ Well DISTANCE TO: No. of li9es Length of each line / Top of tile to finish §fade Absorption area Mt-~er 1DaWel/i~2g Inside length W dth Dwe ng Total length of lines Material beneath tile Length Width Depth Type of crib Crib diameter Well DISTANCE TO: LOCATION Crib depth Building foundation Class Depth DISTANCE TO: OTHER PIPE MATERIALS S©IL TEST RAT~N~ Material N~rest iot line T~e~¢h ~idth ~'g'~" inches inches Total effective absorpti~ Nearest lot line Distance to lot line Septic tank 1411 NO. O/~F]B EDROOMS PERMIT NO, No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO_ Distance between lines Total effe~tiv~ abso/P, tion area INSTALLER REMARKS APPROVED DATE LEGAL DEF'AR]]~'IEI".IT Ill- I-IEALTH AI',ID ENV~ROI"IMEI"I"FAL. l::. JTECTIDN C'( .:~TI'~EE I .~ (-II".ICHGRAGE, AK 9950.1. ~ t~--,C_-¢~ (.. i,~)L~}~'< - 82D I- c ...................... "' 2'64.-472,~() ~:~ [~4t ..... ~:E~ ][ "'fl'"' IE~:: '.!~ EC &,,,J [E: [[:4[ f?' EE F',;~ fl"'fl :lC. 'IF [],,.~, 4,-.., 8 07 / 19/85 APPLICANT: A [.) D R E S S .- CONTACT F'IaISNE". L,,EGAL DESC, R I P: LOT SIZE-" MAX BEDROOM8: JIM BRINKER 3. 1000 HIDEAWAY L.AKE DRIVE AqCHORAGIF.., AK 99502.' ..:, 4 ;~ - ,,~ ~ ,,,J SL.IBDIVISION~: HIDEAWAY LAKE SECTION: 24 TOWNSHIP: 46129 (SQ.FT. I]R Al)RES) 4 Li. sted below are the options available t.c~ ycJu in designing your septic system. C,h¢ose the c:~pi:ion that. best fits your site. DEPTH TO F']:PE BO'I"TON (FT.) 4.0 4,,0 4.0 GRAVEr. I_.. DEF'TH (Fry.) :t(),, 0 O. 5 3.5 "['OTAL. I}EI:~I"H (FT.) :1.4.0 4.5 7.5 GRAVEL~ WIDTH (F"I".) 2.5 22.0 5.0 I~RAVEL, L.I~NGTla (FT.) ' :]; ~.,, 0 42.0 66.0 GRAVEL VOLUME (CU~YDS.) 30.~ 34.~ 4S.9 ]"ANK SIZE (GALS) 1,2[~0.0 ~"~' 1,250.0 .~' ~,25(),,0 *~' SOIL RATING · ~--~. TANK MUST HAVE AT LEA,Ci;T TWO 13tSMPARTMENTS I c:ertify that: 1. I am familiar w:i. tl"~ the require, merits flor on-site sewers and wells as set. forth by the Municipa].[t.y ef Anchc~rage (Mt]A) and t. he State of Alaska. 2. I wi].l install the system in accordance wi'Eh all MOA ccJdes and regulat:i, ons, and in compliance with the design criter:i,a ~:~ t.h:Ls permit. 3,, I will adhere 't.o all MGA and State of Alaska t"eqLlif'E~.lel~ts lop t.h[~ ~ie'E back clis't, ances t'r~)m any existing well, wastewater disposal system of public sewerage system c,"~ -t,h:i.s or any adjacent c~r nearby lot. 4,, I under'stand Chat thi, s permit is va],id [or' a maximum of 4. bedrooms and any enlargement will require an adcliti~nal perm:i.t. :IF' ~ L. IFT S'I"A'I'ION IS INB'I'~I..LED IN ~N AREA EOVERE:O BY MGA BUILDINB ()Gl)ES, THEN (:1,) AN EL,EC"rRICAL PERMI"F AND INSF'ECTICIN MUST BE OBTAINED; (2) AE;-BUILTS WIL.L NOT BE AF'PROVI~:D WITftE]UT AN EL. ECTFIICAL INSF'ECTION REPGRff:~ AND (3) TI-IE ELECTRi[;AL W[)RK MUST BE DONE BY A LICENSED ELE.[',TF(IEIAN. AI::'PI.., :[ EAN'f': J I~"1 BR INKER SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [] PERCOLATION TEST 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: ~ //L// ~/~ l/eX-j~-,~¢-- DATE PERFORMED: LEGAL DESCRIPTION: /~ ' "~/~ , /'~- // // / D ('~ /I bo ?¢ t.,J L-/~-I(,~- Z$ (-,, /_2,~, 1 2 3 4 5 6 7 8 9 10 11 12 -13 20- COMMENTS SLOPE IF YES, AT WHAT DEPTH? SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop / " ~' 4~ P .... ~o~,~,'~, ~], 6 o, ~ Z " :~ ' / ~ P' *~ ~ ~ ~,~, ,',~, ~, q o, ~ PERCOLATION RATE ¢.-z~ yt 2- ~ ""~ (minutes/inch) TEST RUN BETWEEN ~2' FT AND ~ FT PERFORMED BY: /~, '~' ~ ~ ~ CERTIFIED BY: .~¢- DATE: 72-008 (6/79) 2515 A ST., ANCHOF~AGE 99503 (907) 2'/6-4245 Dec. ember 5, 1977 I,Ir~ Bob Sparks 835 "D" Street, Suite 401 Anchorage,, Alaska 99501 Proposed Hideaway Lake Subdivision Sursurface Soil Investigation Dear Hr. Sparks: This report presents the results of our soils investigation for the proposed subdivision of an approximate 25 acre tract located East of Hideaway Lake and south of Upper O'Halley Road. 'The investigation .was conducted on November 28 to December l, 1977. The results of that investigation are 'included in this report as follows: Vicinity Hap Test Hole Location Sketch lest Hole Logs (Sheets 1 through 15) Summary of Laboratory Test Data Standard Explanatory Information Drilling was accomplished utilizing a mobile drill B--50 mounted on a flex track Nodwel vehicle, owned and operated by Denali Drilling, Inc. The test holes were logged and perculatio] test:s conducted by our firm. Harding-Lawson & Associates performed the 'laboratory test data on grab samples taken during Lbe drilling operation. l~he purpose of the investigation was to provide sufficient soils data for establishing the feasibility of on-site disposal of sanitary waste using seepage pits. To accomplish this, we drilled 15 borings.'distributed across the site as shown on the test hole location sketch. The borings were located one on each lot at the most probable location of' a future septic system. During the drilling, our engineer was present to log tile materials encoun%ered and to obtain grab samples of the soil types. All soils were V'isual'ly classi- fied 'in the field 'in accordance with the unified soil classification system as described herein. The grab samples were brought back to the laboratory for further analysis and verification of the field logs. In addition to the soil sampling, several perculation tests were conducted. Based on visual classification of the soil types during the logging of the test holes, the areas with probable higher perculation rates were identified. One or more perculation tests were then conducted in each of these areas. EARL D. KO~IYNTA~ RE. ~,3~,,D(IN D. UNWIN RE. LEO SCHEBEN~JR.,P.E.~L.S. Mr. Bob Sparks December 5, 1977 Page Two SITE AND SOIl.. COIIDITiONS 'lhe site is a 990 foot square parcel with an additional 330 foot square parcel in the southeast corner, tlideaway Lake occupies approximately 5.6 acres of the northwesterly portion of the site as determined by the lake line meanders. Drainage enters the lake along the southerly shore line through the proposed lot 2, Block 1. Site topography is very irregular, especially in the northerly half. tiowever, general drainage -is toward the lake at an average 12% to 15% slope. There are no areas within the parcel which slopes in excess of 25%. The site is primarily underlaying by sands and gravels to the depths explored (t6'). The granular material is well bedded and well graded, with fines ranging from little or none up to approximately, t5%. The surface of the site 'is blanketed by an organic mat of forest du'Ff or peat ranging in depth f,ro.m~6 . Underlying the organic mat is a layer o'F fine organic ~Y"6'F-E~lty sand (top soil) ranging in depth of up 'to 3 feet. A very dense sandy gravelly silt layer located approximately 12 feet .to 14 feet below the surface underlies the southeasterly corner of the site. Apparently this dense stata prevents further penetration of the surface infiltration. There- fore, J~_ree w~t~er~tered at the time of drilling in test holes lO~ _ hr-u qh betv----Teeqi the and this dense str~_jata. Based on the observed field perculation rates, visual test hol laboratory test data, on-site sanitary waste disposal systems Minimum perculation rates for the proposed lots are estimated Block l, Lot t 2 rain/inch Lot 2 - 2 rain/inch Lot 3 - 6 rain/inch ~-'~ Lot 4 -~ ~ rain/inch Lot 5 - 6 min/inch _ Lot Lot We hope this clarifications e logs and appear feasible: as follows: Block 2, Lot 1 - 9.2 (measured) Lot 2 _ 8 Lot 3 -'15 Lot 4 -'15 Lot 5 .- 15' mi n/inch (measured) mi n/i rich mi n/i rich min/inch (measured) mi n/i nch 6 - 6.3 min/inch [measured) Lot 6 7 -. 2 rain/inch Lot 7 is sufficient for' your' present needs. If , please do not hesitate to contact Very truly yours, ._X-..- Earl D. Korynta, ~.E. ~- 15 min/incl~ · ~ 15 re'in/inch we can offer further Attachments EDK/cl r .... ~- ~ . ~ \:'% ,-~ ,,/' ~,: . / ~ .' ;;t¢OPERTY BI, OWN AND DESCRIBED HEREON AND '[ION TO EINISH GRADE ANt) BUll DiNG o 5/8 REBAR SET FI-tIS SURVEY THE PROI~ERTY LINE8 AND NO _..ND_EASt:N~.NTS.A ~i __ _ _ E) 2'k2" HLJB & rACK SET :HCFIO/kCIqMENIS EXIST. [_~ EXISFING El EVATIONS ................... ~ LEGAl DESCIIIPIION: :'~:;.udhy GFRAI_DV FIANDAIL. JR R*,g. Land Surveyor / ~1~ ~ ] ~ZL ~l~- E)ATUMASSUMED I~3~Y, ESI 8,HAVL.,,U E5 ~ SCA E ,¢ / I PI,om:: 2797414 () r '; t.>i , _.. PROJEC'T Hidden ' (}tlEiqT Bo', ~ 'r'i:s -1 [¢S'1- HOi.[{ NO. El EV. -fOP OF lc) .E. ~-~ ~j -' Damp, br'o',,,'n, sandy gravel? 0 i 2 I 0 ..... t2 .... .... 2.1 brown DRILLING, INC. DRILLING LOG Well Owner_ ............................................. Use of ~ell I~ocation (address of: Township, ~an~e, ~ectJon, if known; c,r diManc'e main road Size of casing._ __6*' Depti, of iiole_~ ...... feet Cased to_?_)_u~ _ feet Static water level.~ ..... ft. (~) (below) land surface. Finish of well (cheek one) open end ( ); Screen ( ); Perforated ( ). Describe screen or perforation~ Well pumph',g test at ....... gallons per (hour) (minute) fi,r. ? hours ,v'tl~_J_TZS~ ........... ft. o~ drawdown ~rom static level. Date of completion WK-LL LOG Depth in feet from gFound surface Give details of formations pehe4a,t.,,, sixe of material, color and hardness & associates,inc. Consulting Engineers ~'q~°*~-~ OF ANCHORAGE 1000 E. Dimond Blvd. · Suite 205 · Anchorage, Alaska 99515 · (907) 522:1'311~F HEALTH & · .,; ~" · ',,, rzNTAL PROT~TION August 19, 1988 Mr. Dan Roth Municipality of Anchorage Department of Health & Human Services 825 L. Street, Fifth Floor Anchorage, Alaska 99501 i, CEIVED SUBJECT: REQUEST FOR WAIVER OF WELL TO FIELD ON LOT 4A, 1, HIDEAWAY LAKE SUBDIVISION Dear Mr. Roth: BLOCK As per our telephone conversation, the trench system installed on Lot 4A in 1985 is 96.5 feet away from the well on Lot SA. This situation was created during installation of the trench which was inspected by Mr. Robert Schilling, CE-1411, and approved by your department on August 13, 1985. While this installation was in violation at the time, no waiver was issued or granted at that time. We are hereby requesting a waiver for the separation distance to 96.5 feet. our firm (Mr. Thom Fischer who is no longer our employee) performed a Health Authority Approval on February 2, 1988. At that time we did not complete the forms incorrectly, but the situation on Lot 5A's well was not flagged separately. We do not feel we have an obligation to pay for the waiver request nor do we feel the current owner should pay for the request. Niether of us created the situation~ Also, both Mr. Robert Schilling and your department issued approval for the construction of the trench and a permit for the construction was issued and the final approval appeared in your files. This would not lead anyone to believe that there was a problem with separation distances. We feel the waiver should be granted for the following reasons: 1. The trench located on Lot 4A is designed and located such that flow is away from the well located on Lot 5A. Natural drainage occurs from the well on Lot 5A toward the septic system on Lot 4A and not visa versa. There is little possibility that flow will move from the septic system toward the well. 2. The soils in the area are sands and gravels nearly 70 feet deep providing positive treatment of any effluent prior to arriving at any local aquifer. Mr. Dan Roth August 19, 1988 Page Two 3. The well on Lot 5A is similar to the well on Lot 4A in that there is hardpan nearly 70 ft. deep which would stop any infiltration into the aquifer even it it did arrive untreated at that point. 4. Static water level in the well on Lot 4A is approximately 50 ft. deep and any impurities in the effluent will be treated by the time the fluid reached this level. We see no reason why your department cannot grant a waiver for the separation distance on the trench on Lot 4A to be within 96.5 feet of the well on Lot 5A. Since we have taken the time to submit this request and completed 'the research free of charge, we feel we have done everything in our power to aid your department in this situation. Further, since your department issued the permit and approved the trench on Lot 4A, we feel you have an obligation to approve this waiver without fee to the current owners of either Lot 5A or ]Lot 4A. Should you have any further questions or need any additional information, please let us know. Very truly~yours, .CO~IN & ~S~$©~IATES, INC. I' . ,, ~ President xc: ~r. Buz Hoffman Mr. Lee Browning Tom Fink, Mayor N unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 August 1, 1988 Juanita E Hoffman 11000 Hideaway Lake Drive Anchorage, Alaska 99516 Subject: Septic System Located to Close to Neighbors Well Lot aA 8lock 1 Hideaway Lake Subdivision Dear Ms. Hoffman: It has recently been brought to my attention during the Health Authority Approval process for your neighbor's lot, lot SA, that your septic system is located 96.'5 feet from his well. The required separation distance as stated in Title 15.65, Municipality of Anchorage Wastewater Disposal Regulations, Section 15.65.040, (I.1), is 100 feet. Your neighbor cannot receive a full approval of his well from the department until this matter is resolved. Because the date of the upgrade to your septic system is August 8, 1985, and your neighbors well was in place at the time, the responsibility of correcting this matter would be yours. The two options available to you to correct this matter are: (1) You may hire an approved engineer 1:o perform a waiver study on the 96.5 foot separation to determine the possible impact on the well water and submit it to the department for approval, or (2) you may apply for a permit from the department to upgrade your septic system to meet the required 100 foot separation distance from your septic system to the well on lot SA. You must bring you]: septic system into compliance by August 31, 1988 or the department may take legal action to have this matter resolved. If this deadline is unreasonable or yo~ have any questions reqardin~ the above you can contact me at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-Site Services cc: A1 Sundquist, P.E,, Manager On-Site Services/Water Quality Programs Parcel I.D. 015-471-08 U4 gUi Municipality of Anchorage =°` ' On -Site Water and Wastewater Programfi e (907)343-7904 saf�,r Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: Complete legal description Hideaway Lake, Block 1, Lot 4A Location (site address) 11000 Hideaway Lake Current Property owner(s) Stephen Lesko Day phone Mailing address 11000 Hideaway Lake Real Estate Agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ P ibiic Water Systeirn ❑ Public $e'vder ❑ WaiverNariance request for: OR Distance: Received by: Date: 71,Y11 3 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ `-t" tcj Waiver Fee $ Date of Payment � Uwe r Le, Date of Payment Receipt Number Co -1 "t v Receipt Number COSA#- ODIC -1 �1 Q'kD 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE 1 _�z System #1 Approved for T bedrooms System #2 Approved for _ bedrooms Disapproved Conditional approval for Phone (907)272-8218 Date 6/24/13 bedrooms, with the following stipulations: Bv: �Original Certificate Date: -7' _ I� Th& uni ' ali of chorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Use sheet r '- c If more than 1 septic system is on the lot: COSAChecklist# I of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description Hideaway Lake, Block 1, Lot 4A Well type Private If A, B, or C provide PWSID # Date completed 10/6/78 Sanitary seal (Y/N) Y Total depth 77 ft. Cased to 77.1 ft. FROM WELL LOG Date of test 10/6/78 Static water level 50 Well production 10 ft. 9 -p.m. Parcel ID: 015-471-08 Well Log (YIN) Yes Wires properly protected (Y/N) Y Casing height (above ground) 42 in. AT INSPECTION 6/24/13 58 ft. 5.2+ 9 - p.m - WATER SAMPLE RESULTS: Coliform PASS colonies/100 mL Nitrate 4.7y mg/L Arsenic O.V 3 y ug/L Date of sample: (c 4qll3 Collected by: P G S B. SEPTIC/HOLDING TANK DATA TankType/Material S.T. E. P. / Steel Date installed 10/23/00 Tank size 1,500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/ ��N )) N High water alarm (YIN) Y Dateofpumping G/,17/13 Pumper A 4 //c)w e >�":C_e5 C. ABSORPTION FIELD DATA Date installed Length 60 10/23/00 Soil rating (g.p.d./ft2 orfe/bdrm) 1.0 GPD/SF 25 System type Deep Trench ft. Width • ft. Gravel below pipe 10 ft Total depth 14.3 ft. Eff. absorption area 1200 ftp Monitoring tube Y Depression over field N Date of adequacy test 6/24/13 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 31 in. Water added 604 gal. New depth 46 in. Elapsed Time: 280 min. Final fluid depth 31 in. Absorption rate , 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date D. LIFT STATION Date installed 10/23/00 44 "Pump on" level at-4.?- tm n Datum Bottom of Tank E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons 250 "Pump off"level ar*" ain. Cycles tested 5 Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ Manhole/Access (Y/N) Yes High water alarm level at 45 in. Meets alarm & circuit requirements? Yes On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 110+ Water Service line 10+ Curtain drain 50+ F. COMMENTS G. ENGINEER'S CERTIFICATION Surface water 100+ Wells on adjacent lots 100+ I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date COSA brown sheet 10-10-12.doc 6/24/13 Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ .Ra.oxa Imaaa nom Puee(As9Ren, IrAwT eI511m 115 aT, sLanw sroAa s� caauN 9Elaux �T3, ga' 12"� N �'23•Ssp ,ew wa.a.c ac,aAa W (V yM1aa ..'..'......'..'..'.'.'.'..'.. W WELL 1M1 .�:. .................... . EXISTING p HED HOUSE 1M1� .- - ... --.. ... _,. _ .... i 30, d ................ .. ... ... ............ .. ... ! 5A UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY, LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE, Lj LOT WRIEY SURVEY TYPE ❑ FaINwArKal SYMBOLS As-euLr ❑ FINAL STRUCAME AS-BULT ... ' SET REBAR 7 ;w DRAINAGE I ASPHALT ❑ L.ar LAN ... AS -B ...Lor SURVEY TaN O FOUND REBAR gig. y7000 FENCE "I� CONCRETE AG BUL El S AS-BUILT ... N ERS RECSiBFlCABON As -B R.T ... N s IRC 00 ASSUMED ELEV. * -K—X- ® METAL FENCE ® WOOD DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED, WHICH 00 NOT APPEAR ON THE RECORDED SUBDIVISION PLAT, ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION •��`��U1111 .••- Prepared by Robert E. Johns, Jr. & Assoc. PLOT PIAN '�rwah «a'naw rRrm4 w...e.� �•♦�P,.••• .,•'�� Professional Land Surveyors 1700 Brink wwN.en «e rBa« r s..rm. naw e.n ANCHORAGE, ALASKA 99504 Scale: 1 II _ �^, Rea LoS.F. t Rec. Plot File No. i w /- '• - ♦ FOUNDATION AS -BUILT •• • • i ... •• •• •• U 4 RRwe E MK J'.. Rrr> wary Ma Rpw aww.w m AtdA1 a w Moa a« NN w «, aww"'i w I •� „"JO •: • Dote Surveyed, 06/22/13 Drawn by. REJ Chocked by wm«Nm..w aL.nwem « ww« eapn. .. R R JMK Date Drawn: 06/24/13 Gold: 2640 W.0 13-280 w„� ' w'w"""w"' - _ `? ;• ei t RNAL STRUCTURE AS -BUILT t. I. AAv1 E wwA ewr, way awe i • �m '+. .•••' J� • •., . 5 Legal Description: anwee, a MN Ne � awe r w « 4 °d,a '•.•••••' .. ora .• Lot 4A BLOCK 1 W M ro wwWnei6 «Yl vM« 11% se :•.••• HIDEAWAY LAKE Pannone Engineering Services - PES Attn: Dan Moran P.O. Box 100217 Anchorage, AK 99510 907-272-8218 Fax: Client Sample ID: Sampling Location: Client Project: Sample Matrix: COC #: PWS#: Residual Chlorine: Comments: 11000 Hideaway Lake Well -Safe Program Drinking Water Lab#: A1306382 -01A Analytica Group, LLC -Anchorage 4307 Arctic Boulevard Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 Report Date: 7/1/2013 Receipt Date: 6/24/2013 Sample Date: 6/24/2013 Sample Time: 11:45:OOAM Collected By: Nick Flay Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank H = Exceeds Regulatory Limit M = Matrix Interference J = Estimated Value D = Lost to Dilution ** = RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Chk NO2=recommend nitrite test Anatysrs ivietnou Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate+Nitrite pres Nitrate -Nitrite as Nitrogen 4.74 mg/L Lab#: A1306382 -01B Test was conducted by: Analytica -Anchorage Chk NO2 0.50 10 6/27/2013 6/27/2013 MC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 9223B -PA (Aqueous) - Coliforms in DW Test was conducted by: Analytica - Anchorage E. Coli Pass PASS/FAIL 1.0 Total Coliform Pass PASS/FAIL 1.0 Lab#: A1306382 -01C 6/24/2013 6/24/2013 KM 6/24/2013 6/24/2013 KM Anatysrs tvtetnoa Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 200.8/200.8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton Arsenic 0.434 ug/L 0.15 10 200.8 6/28/2013 6/28/2013 RM Page 3 of 9 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION '~ W4L $~_~, '~'~02Ao~ DIVISION OF ENVIRONMENTAL HEALTH ' OERTIFICATE OF ON-SITE SEWER AND WATER FACILITY Ap¢~cation Dato GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) koT 4LA Location (address or directions) Applicant Name _i~.Rfk-/~-/~ ~-~T'~r~elephone: Home Applicant Address ,~t41T~ I G.~ / ~---,01 ~' NJO,~---I"H~'"¢_...,'~ ~,..~,(.t'¥fI~ Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other,¢~ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-FamilyJ~2' Multi-Family [] Number of Bedrooms Z¢- Other WATER SUPPLY Individual Well~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72025(1184) ENGINEERING FIRM PROVIDIN. ,NSPECTIONS, TESTS, FILE SEARCH, DA . AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, [ verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address ~ Date ~----/%/~¢::~ Telephone ineer's Seal DHEP APPROVAL Approved for ~ k//~'/--//~ bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANC'HoRA(3F~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION FEB 1988 RECEIVED MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4744 Legal Description: WELL DATA 'T ~Z. J"~, ~--- Well Classification __~::~::~,~ ~i ~k"T'~' If A, B, C, D.E.C. Approved (Y/N) _ Well Log Present (Y/N) k¢.~ Date Completed I ~)/& /:'7 8 Yield Total Depth '"7 '7 Cased to '"~ ~7 Depth of Grouting Static Water Level ~:~C~ / Pump Set At Casing Height Above Ground __ ~ ~,~¢ .a¢- Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) ~"~;~ Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ~ O~,~ '4-- - ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~%.~¢¢ ~'~r~ ; On Adjoining Lots _ To Nearest Public Sewer Line ~,1 f Cf To Nearest Public Sewer Cleanout/Manhole t,,,,~/ ~';~ To Nearest Sewer Service Line on Lot Water Sample Collected by "'~--Mc;~vv,. ,~. F'~ 5~-t~-'~z- ; Date Water Sample Test Results 2..,, '~' t~(,~ hQ ¢~¢¢¥[f=~ --~ ~,~&.~,,o¢'ilC, LE~- ,~: Comments B. SEPTIC/HOLDING TANK DATA Date Installed "-/ Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) N Separation Distances from Septic/Holding Tank: To Water-Supply Well __~ To Property Line I ~ ~ "~- To Water Main/Service Line 'Z ~..,, ' Course ~ (~) ~ I'Z.~-o Size ~L~cx::) No. of Compartments "~... Air-tight Caps (Y/N) ~-;---,% Foundation Cleanout (Y/N), ~',~C) Date Last Pumped t'~/V:~ ;for Temporary Holding Tank Permit (Y/N) To Building Foundation ~ (o / To Disposal Field ,4~_¢~ / To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026 IRev R,'86~ Fronl ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ? !~''7 f '~;~" Width of Field Z~ ~ ~' Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~ To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ¢ /j~ic. vrl Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line ~ ~ ~fF To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) ~'~.~/¢~' 4L5j Comments D. LIFT STATION Date Installed Dimensions Size in Gallons , , /~&~-~ Manhole/N) "Pump On" Level at at~'''-2 / ~ '/*'~P ~ m P Ovf~"n~lNit / High Water Alarm Level Tested for Pumping~MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, v, ed?'i-~o r conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed '"~ ~ ~"~-- Date Company ~:="¢~'~'~4~ ~ ~;~'-MOA NO. Receipt No. f' ¢'~/ (-/~3~ .c:'. : ~ '",~, Date of Payment ~ - c~ ~ OC'L'~ ..... Amount: $ / 7 0 ~ Page 2 of 2 ¢ 72 026 fRev 8~B61 Back CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ANALYSIS R~ORT BY S~MPLE Client PO# : VERBAL Req #: Client ~l ID: LOT 4A BLK 1 HIDEAWAY LAKE Sample Dec'd : JAN 28 88 Ordered By : TH~ FISCltER Dend Reports To: CORWIN & A~OC THOM FI~H~ 1~0 INDUbTRY WAY, DLDG B, #11 ANCHORAGE, AK. 99515 Work Order No, : 4946 Client Account : CORWINP Date Report Printed: FEB 1 88 g D:41 Released By : 2,~,~-~ Reports Addre~J #2 ~peclal COLLI~I~D 1-28-88 g1330 ERS BY THOM FISCHER Instruct: Chemlab Ref #: 89~8 Lab ~1 ID: 1 Matrix: Water A110wable Para. ret Tested Result/Units Method Limits NITRATI~N 2,5 mg/I ~PA 353.2 Sample ROUTINE SAMPLE Remarks: ANALYSIS COMPLI~i'ED: 1-29-88 ........... .............................. 1 Tests Performed ND= None Detected NA: Not Analyzed * See ~peclal Instructions Above ** See S~mple Remark~ Above LT:Less Than, GT=Greater Than CHEMICAL & GEOLOGICAL LABORATORIES O,F' ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER .-~'~d:~RIVATE WATER SYSTEM Name Mailing Address / '~-~~- City SAMPLE DATE: ~-~ MO. Phone NO. State Zip Code Day Year TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ~¢~ Saris factory [] Unsatisfactory D. Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received l SAMPLE TYPE: <-'.~:~ou tine [] Check Sample (for routine sample with lab ref. no, [] Special Purpose _) [] Treated Water ~ Untreated Water Analytical Method: Membrane Filter * No. of colonies/100 mi. SAMPLE NO. 2 I 3 I 4 I Time Collected LOCATION Collected B.y __1 I Lab Ref. No. Result* J J BACTERIOLOGICAL WATER ANALYSIS RECORD Analyst Coilformll00ml a.m. :~'t Membrane Filter: Direct Count READ [NSTRU____CTIONS ;, 1verificad°n: LTB__ , BEFORE ' ~ Final Membrane Filter Resul s~/~-''~-~¢// COLLECTING SAMPLE !Reported By i ~ Time: TNTC = Too NumberoUs Tff Count OB = Other Bacteria p;~r?T ~ OF Z REt4AIr4oER TO FOLLOW CoilformllOOml RECEIVED INSPECTION APPOINTMENTS D^TE DATE DATE - ,MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~IRONMENTAL PROTECTION 825 L Strset - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION NOV ~ 0 1979 Telephone 264-4720 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. PROPERTY OWNER j PHONE MAI LING'ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. ~ENDING INSTITUTION PHONE M~ING ADDRESS 4, REALTOR/AGENT J PHONE- I MAILING ADDRESS 5. LEGAL DESCRIPTION STR E ET LOCATI ON 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS [] One ~ Four L/.J.~ blNG LE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~'~'~Three E] Six [] Other ?, WATER SUPPLY 12~'~N DIVI DUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A wel Icg is required for all wells drilled since June 1975, For wells drilled odor to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM E]~"~'N DIVI DLJAL/ON-SITE** [] PUBLIC UTILITY /¢7? YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIViDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER I~Septic Tank or [] Holding Tank Size:./.~2.~-~5 If Tank is homemade SOILS RATING give dimensions: ~ .~'~- TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [] CONDITIONAL APPROVAL {letter must accompany certificate) [D DISAPPROVED DATE BY