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HomeMy WebLinkAboutLAKEWOOD HILLS #4 BLK 1 LT 7Lokewood Hills lock I Lot 7 015-134 -25  Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program, 4700 Bragaw St. ~ P.O. Box 196650 Anchorage, AK 99519-6650 ~ www. ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: OSP 111243 PID Number: 015-134-25 Name: ELIZABETH GOODRICH WastewaterSystem: [] New · Upgrade Address: 10541 ELIES DR *ANCHORAGE, AK 99507 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 546-1435 3 [] Deep Trench [] Shallow Trench · Bed []Mound BOther LEGAL DESCRIPTION so,, Rotlng: Total Depth, ..... icJinol grade: 0.8 GPD/Sq. Ft. 12 MAX Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 1 7 LAKEWOOD HILLS #4 4 MAX rt. 8.0 rt Township: _ Range: _ Section: NIl added above original grade: Gravel length: SEE DWG. Ft. 2 @ 20 = 40 WELL: [] New [] Upgrade Gravel width: 2.5 Ft. Number of 2 Ii .... Dist .... lb~ .... Ii .... Ft Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: PRIVATE 114 Pt. 114 rt. 640 sQ. rt.D 3034/ F-810/HDPE Driller: Date Drilled: Stotlc Water Level: Installer: Date installed: ALPINE DRILLING 10/5/11 84 Ft. A+ HOME SERVICES 9/15-15/11 Yield: Pump Set At: Casing Height Above Ground: 10 GP. 1 03 Ft. 2+ rt. TANK SEPARATION DISTANCES [] Septic [-I Holding E] S.T.F.P. [] Other* T~rom~'~"~° Septic Absorption Lift Holding Public/Privat( Manufacturer;. Capacity in gallons: Tank Field Station Tank Sewer Lines ANCHORAGE TANK 1250 Material: Number of compartments: WaR 100'+ lO0'+ - - 25'+ STEEL 2 Surface Wo~er ~00'+ ~00'+ -- -- -- LIFT STATION Lot Line ,5'+ 10'+ _ _ _ Size in gallons:IJ Manufacturer: "Pump on" level at: "Purr alarm at: Foundation 5'+ 10'+ - -- -- Curtain Drain ' NONE KNOWN ~ Pump No__cai Inspections performed by: I I Remarks: OLD TANK WAS DECOMMISSIONED PER UPC. BENCH MARK Location and Description: OLD TRENCH WAS ABANDONED IN PLACE. BOTTOM OF TRIM ON SE CORNER OF HOUSE OLD WELL WAS DECOMMISSIONED PER UPC. A~ .... d Elevation: 97.93 Ft. ENGINEER'S SEAL Inspections performed by: CEC, Ltd. Dates: 1st 9/13/11 2nd 9/14/11 ~',<, %,, ......... ~-1 3rd 9 / 14/11 ¢¥~.~%.. · ' ' ' ' ~'"'. Development Services Department Approval ~.~i.i...4..9, Conditional approval: Date' ¢,:: :: :. ......... ':: ..... ........... ~ ¢ '-.Jeffrey -A. _Garness.: v~k~. ".. CE-7955 .." PERMIT NUMBER: OSP1 1 124.3 / / / / ? / / / / / / / / SHED / / / I AS-BUILT DRAWING [ A ~ C ST1 87.11 64.5.3 78.26 ST2 95.40 72.91 86.75 DBL1 58.05 44.80 29.06 DBL2 58.19 44.79 29.08 DBL5 96.79 74.95 88.91 DBL4 96.48 74.90 88.96 C01 87.82 68.82 85.59 MT1 78.75 59.55 74.22 C02 68.06 48.90 64.05 MT2 70.27 60.05 75.79 C03 51.46 43.86 59.54 C04 70.89 60.56 76.14 MH 59.24 44.60 28.97 PARCEL ID NUMBER: 015--1.34--25 / / / / / / / / / / / / / I I 100' WELL RADIUS 24" DIAMETER ORENCO PUMP VAULT WITH 2" SOLIDS TRANSFER PUMP & ORENCO CONTROL PANEL. / 2" HDPE (NO JOINTS I PROFESSIONALLY J-/ IL°cATED/ EXISTING 3 BEDROOM DRAINFIELDS LONG EACH) SCALE: \ I I \ 1" = 40' NEW 1250 GALLON/ SEPTIC TANK ~ / / G-A:R'N'ESS ENGI'N'EERING GROUP, Ltd : C:ON8 U LTANTS & GE N E~AL G ONT~GTO ~ * ~: www.gamessengineefing.~m PREPARED FOR: PHONE NUMBER: PAGE NUMBER' ,AX~WOOD ,~,,s ~ ,LOCX ~. ,OT 7 I w ~s-,u~LT ~<w~,~ I ~o/~/1~ PERMIT NUMBER: AS--BUILT DRAWING PARCEL ID NUMBER: 0SP111243 015-134-25 f FINAL GRADE = 104.81-104.93 ST1 / ST2 TOP OF TANK t( ~:1 /-- TOP OF TANK AT INLET = 100. ~ ~A1AT OUTLET = 100.72 I/ NEW 1250 GALLON INVERT OF BUNG SEPTIC TANK I I X-INVERT OF BUNG AT INLET = 100.22 l/ AT OUTLET = 99.95 FINAL GRADE -~. = 100.25+ NORTH SOUTH GRADE FINAL = 101.25+ GRADE 100.62 FABRIC FABRIC OF PIPE = 96.62 OF PIPE 95.76 16'+ BoTroM OF TRENCH = 88.62 BOTTOM OF' TRENCH = 87.76 RELATIVE ELEVATION OF BOTTOM OF TESTHOLE @ HIGHEST POINT= 82.62 (DRY) RELATIVE ELEVATION OF BOTFOM OF TESTHOLE @ HIGHEST POINT= 81.76 (DRY) GARNESS . G IN EER. I. NG G iR.O'U P, Ltd~ CONStJLTA~NTS & GENERAL CONTRACTORS PREPARED FOR: I PHONE NUMBER: ELIZABETH GOODRICH I 346-1433 LEGAL DESCRIPTION: LAKEWOOD HILLS #4; BLOCK 1, LOT 7 PAGE NUMBER: 3OF3 DRAWN BY: DATE: PNB 9/21/11 TYPE OF WORK: PROFILE AS-BUILT DRAWING (Rev 0'~/05) FROM :Alpine D~illin@ FA× NO. :907 345 0202 Oct, ll 2011 11:46PM P2 Alpine Drilling & Enterprises Well Log B°rehole Data: Soil Type, Thickness & Water Strata Sack-up 0 2 set 2 7 gravelly silt 7 13 silt 13 19 gravelly sandy silt 19 31 Mlty gravel 31 36 silt 36 54 gravelly silt 54 63 silty gravel 63 81 gravel 81 94 silty gravel 94 102 silt 102 106 silty water sand & gravel 106 114 Permit Number:. #SWOSP111273 Date oflssue: ~10-3-11 Parcel Identification Number: 015~13425000 Date Started: 10-3-11 Date Completed: 70-3-11 Is well located at approved permit location? x Yes [] No Legal Description: Lakewood Hills # 4 Block 1 Lot 7 Property Owner Name & Address: Elizabeth M. Goodrich 10541 Eries Drive Anchorage, Alaska 99507 Depth (ft) Method of Drilling x air rotary [] cable tool From To Casing type: steel Wall Thickness: .250 inches Diameter: 6 inches Dep/h: 114 feet Liner Type: ~ Diameten ~ inches Depth: ~ feet Casing..stickup above ground: 2 feet Static water level (from ground level): 84 feet Pumping level: 114 feet after 2_ hours pumping 10 gpm Recovery Rate:/_0 gpm Method of Testing: ~ Well Intake Opening Type: x Open End [] Open Hole [] Screened Start~ feet Stopped ~ [] Perforations Start __ feet Stopped~ Grout Type: ~bentonite Depth: Start.O feet Pump: Intake Depth __ feet Pump size ~ hp Brand Name __ Well Disinfected Upon Completion? x Yes [] No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 feet · feet Volume: ] bg Stopped ? feet F~× ~0, :907 3~5 8282 Development Services Department Building Sefefy Division On-Site Water & Wastewatev Program 4700 EImore Road P.O. Box 196650 Anchorage, AK 99507 ~w.muni.or~/o~ite (90~ 343-7904 Pump Installation Log Well Drilliug Pemit Number: SW([~/~[//~ ~_~ Parcel ldentitication Number:O/5/' .~'~~ Pump Intake Depth Below Top of Well Casing:./_~ feet' Properly Osmer Name & Address: Pump Manufacturer's Name: Pump Model: Pump Size//~ hp Pitless Adapter Burial Depth: /_~ feet Pitlem Adapter Mannfacturer's Name: /~'/.,4r_~ ~tJe~ Adapter I~taller:~'~.~ Well Disinfected Upon Completion?C~¥es [] No Method of Disinfeetion: Comments: Pump Installer Name: Attention: ) installation log to thc DSD within 30 days of pump installation. Page 1 of 1 Sonja Blewett From: David Harper [dlharper2@gmail,com] Sent: Tuesday, October 11,2011 11:56 PM To: Sonja Blewett Subject: Re: Well Log & Pump Log Sonja, the original well located on Block 1, Lot 7 Lakewood Hills # 4, has been decommissioned as per DEC and MOA requirements. The existing well could not be deepened because of perforations. Depth of the old well was 100 feet. New well depth is 114 feet. David L. Harper Alpine Drilling & Enterprises On Mon, Oct 10, 2011 at 12:34 PM, Sonja Blewett <Son~arnessen~.com> wrote: Do you have the well log and pump log for 10541 Elies Drive. Thanks! Sonja Blewett Corporate Secretary/Treasurer Garness Engineering Group, Ltd. 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Phone: .(907)_ }_37-6179 Fax: 907~8-3246 10/12/2011 APPLICATION NO. 17:05 86@6770 ~PLU$ PAGE Municipality of Anchorage Community Development Department - Development Services Division P.O, 60× 196650 - Anchorage, Alaska 99519-6650 - 4700 EImore Road info and Help: (907} 343-8211 INSPECTION: Voice: (907) 343-8300 Fax (907~ 249-7777 Inspection Report- Electrical Permit Type: Electrical RETROEI.11440 Res Schedule ~~ ~~:' ' Preference:AM;'*; Ad~resSof rolec: 0 ~ ' ' Lega:* LA iLL '1 ' : 4 ' ' ' ' ~$cripti°n"°fW°~ki ~' (907)346.143~ GOODRICH ELIZABETH M ED~S, EbEO,-FR,iC~,iNC P.O. BOX 210767 . ,,, . Cont~a~or (907)272~591 I~ctor Commenm: ' RETRO R-E PERMIT NO. 86@6770 APLUS PAGE 01 Municipality of Anchorage Community Development Department Development Services Division P.o. E~ox 196650 - Anchorage, Alaska 99519.6650 - 4700 Elmore Road Phone: (907) 343-8211 Fax (907) 343-8214 http://www, muni.org THIS PERMIT MUST BE POSTED IN A CONSPICUOUS PLACE AT THE ADDRESS OF WORK UNTIL WORK IS COMPLETED AND APPROVED RETROE111440 1 LT 7 G:2540 Address of P~oject: 10541 EL/ES DR, Anchorage Legal: LAKEWOOD HILLS ~4 BLK Description of Work: RESIDENTIAL ELECTRICAL RETROFIT PERMIT Issue Date: PM: pwwab Expiration Date: Parceh 01513425000 Subdivision: LAKEWOOD HILLS ~ 09/19/2011 09/13/2012 Install electrical for a septic rift system / tb Permittee: ED'S ELECTRIC INC Permit Type: Electrical Owner:. GOODRICH ELIZAEIETH M Address: P.O. BOX 210767 ORUNS, DWAYNE R., ANCHORAGE AK Existing Use: P~'~sed Use: R-3 Address: 10541 ELIES DR ANCHORAGE, AK 995076234 All Work in strict conformance with plan check requirements as per job prints. Field inspection required. Inspection required of foundation excavation prior to placing any classified fill. Contact the utility for approval of service equipment and location pr/or to installation. Service changes must be scheduled in aclvance with the utility cOmpany and the Building Safety inspection sect/on. I HAVE READ THE ABOVE APPLICATION AND KNOW THE CONTENTS THEREOF: THE SAME IS TRUE AND CQRRECT. I FURTHER AGREE THE ABOVE WORK WILL BE DONE IN ACCORDANCE WITH ALL STATE AND MUNICIPAL LAWS AND ORDINANCES. PERMIT EXPIRES IN 360 DAYS IF WORK IS NOT COMMENCED AND NO INSPECTIONS PERFORMED. 3ignature of Permi~tee or Agent: >rinted Name: Permit Number: Tax Code Number: Work Type: On-Site Water System Permit OSPl11273 01513425000 Well MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade Permit Effective Dates: October 03, 2011 to October 02, 2012 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: LAKEWOOD HILLS #4 Site Legal Address: LAKEWOOD HILLS #4 BLK 1 LT 7 G:2540 Owner/Address: GOODRICH ELIZABETH M 10541 ELIES DR ANCHORAGE AK 995076234 Site Mailing Address: 10541 ELIES DR, Anchorage Lot Size in Sq Ft: 46609 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field N SepticTank N Holding Tank N Privy Y 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. Special Provisions: The existing well is to be decommissioned prior to inspection report approval. Received By: "' '"¢~'~'~' ¢''~'' b :" f~'~ ~'? ,"' / / Date: ,- .. Issued By: ~~ Date: / MUNICIPALITY OF ANCHORAGE Community Development Department Development Services On-Site Water & Wastewater Program ~ Phone:907-343-7904 Fax:907-343-7997 Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-1,54-25 Property owner(s) ELIZABETH GOODRICH Mailing address 10541 ELIES DRIVE *ANCHORAGE, AK 99507 Day phone 546-14,53 Site address 10541 ELIES DRIVE *ANCHORAGE, AK 99507 Legal description (Sub'd, Block& Lot) LAKEWOOD HILLS #4; BLOCK 1, LOT 7 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: ( [] all that apply) Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: N/A I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: .~:i~-¢-, :.~¢,~--~.~ ¢_0¢q'~'~ ',~-Waiver Fees: ! Date of Payment: '~'~..;~ ~i ", ~i Date of Payment: Receipt Number: ~i.5 "~,~; ~ ~ ,, Receipt Number: Permit No. ~ '-~ ~ ~ '~- ~ .O Waiver No. (Rev. 01/11) :GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONT~CTORS September 29, 2011 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Well Upgrade for Lakewood Hills #4; Block 1, Lot 7, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing well was recently inspected by Dave Harper at Alpine Drilling and was discovered that the well is not producing adequate water production. We are proposing to have the existing well decommissioned per UPC and have a new well drilled near the same location as the existing well. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any ~stions, please contact us at 337-6179. Thank you for your assistance. / \ ~Sincerely, ~ _~ar'rr~s, P.E., M.S.Presj~te~ NOTE: Attached is a site plan drawing and design drawing. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907)337-6179 * Fax: (907)338-3246 * Website: www.gamessengineering.com I I I ' WELL DRILLER IS RESPONSIBLE FOR I I I VERIFYING SEPARATION DISTANCES FROM ~1 HAMPTON HILLS; THE PROPOSED WELL LOCATION TO ALL I I BLOCK 2, LOT 2 I SURROUNDING SEPTIC SYSTEMS. I _1 la,. LAKEWOOD HILLS #4; ~ I~lJ BLOCK 1, LOT 9 ' I I I 1 //! BLOCK 1, LOT 8 ; //! HAMPTON HILLS; , / / I BLOCK 2, LOT 5 ~~ I ,,'// /I/ ,,' ,, // /// FIELD VERIFY II BLOCK 7. iLOt ~ , k ~ i ~// / ;,,, -.- ~ iiii / / I PROSPECTS HEI~TS ~2; I SCALE: z ~ I I 1" = 100' I ~7~E~D~R~SU~*~cH~E~99~7*PH~NE(~7)~7-6~79~F~(9~7)~-~2~6*W~S~gPREPARED FOR: PHONE NUMBER- , PA~E ..... NUMBER:gineefing .... ~'~ ~/~ ...... ~.. ......... ELIZABETH GOODRICH I 346-14~3 I 1 OF 2 ~'F~h~~e//ey~Ge ness.-' LEGAL DESCRIPTION: D~WN BY: ~ "~ rCE~n .-" ~p~ of wo~x: ~A~:~ SITE PlaN (WELL PERMIT) 9/29/11 WELL DRILLER IS RESPONSIBLE FOR VERIFYING SEPARATION DISTANCES FROM THE PROPOSED WELL LOCATION TO [~L~ SU RROU N DING SEPTIC SYSTEMS. \ / \ \ ~ ....... _ 1-- .... /..~~~ ~' I ---- .. Il ////-EXISTING WELL TO BE X ~ P~PO~D ~LL SCALE: 1" : 40' G. ARN'ESS ENGIN'iEER]NG G, RO:UiP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 E. I~JDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 * PHONE (907)557-6179 * FAX (907)558-5246 * WEBSITE: www.gamessengineering.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ELIZABETH GOODRICH 346-1433 2 OF 2 LEGAL DESCRIPTION: LAKEWOOD HILLS #4; BLOCK 1, LOT 7 IDRAWN BY: PNB DAT~;9/29/11 ~'PE OF WORK: WELL DESIGN ]rness.. Permit Number: Tax Code Number: Work Type: On-Site Wastewater Disposal System Permit OSPl11243 01513425O00 Septic 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 Upgrade Permit Effective Dates: September 12, 2011 to September 11, 2012 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: LAKEWOOD HILLS #4 Site Legal Address: LAKEWOOD HILLS ~, BLK 1 LT 7 G:2540 Owner/Address: GOODRICH ELIZABETH M 10541 ELIES DR ANCHORAGE AK 995076234 Site Mailing Address: 10541 ELIES DR, Anchorage Lot Size in Sq Ft: 46609 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank 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. Date: c')//// g~//// Date: (~~--//~/ MUNICIPALITY OF ANCHORAGE Community Development Department Development Services On-Site Water & W~tewater Program fldSH! Parcel I.D. 015-134-25 Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Property owner(s) ELIZABETH GOODRICH Mailing address 10541 ELIES DRIVE *ANCHORAGE, AK 99507 Phone: 907-343-7904 Fax: 907- 343-7997 Day phone 346-1433 Site address 10541 ELIES DRIVE *ANCHORAGE, AK 99507 Legal description (Sub'd, Block & Lot) LAKEWOOD HILLS #4; BLOCK 1, LOT 7 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: ( [~all that apply) Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: N/A I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) ~o~q 17 ush Fees: Date of Payment: Receipt Number: Permit No. O'~¢ Waiver Fees: Date of Payment: Receipt Number: Waiver No. (Rev. 01/11) GARNESS ENGINEERING :GROUP., Ltd. CONSULTANTS & GENERAL CONTRACTORS September 6, 2011 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic Upgrade for Lakewood Hills #4; Block 1, Lot 7, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgraded. We are proposing to install a new 24 inch pump vault, a 1250 gallon septic tank, and a dual deep trench type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfieid specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached topo drawing the topography around the drainfield runs south to north at approximately 20% slope. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any q~,'stions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd..for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com I I HAMPTON H LLS I I BLOCK 2, LOT ~ I _1 ,5, LAKEWOOD HILLS #4-; I I T"-~ I~ BLOCK 1, LOT 9 )/) ~ ~ ~KEWOOO H,LLS ~, //! BLOCK 1, LOT 8 ; I/I HAMPTON HILLS; I /// BLOCK 2, LOT 3 / ~ ~ -- ~ ~ m // II/ ,' , , HEIGHTS ~2; m ~ BLOCK 7, :LOT 3 / ~~ PROPOSED SEPTIC  SYSTEM HAMPTON HILLS: / / / ', ~ "'X .~KEWOOD HILLS ~4[ I /// ," .---~<-~r--" ~, GA~N'.ESS ~.~-~ /~~ .... ':.~.:~ PREPARED FOR: m PHONE NUU.~.: I PAGENUMBER: [1, z,,[~H OO0~,,CH m ~-,~ m , o[~ ~~~;~)~..-~ LEGAL DESCRIPTION: DRAWN BY: ~'~h~. I'/. ~E-795~ ..' ~/ LAKEWOOD HILLS ~4; BLOCK 1, LOT 7 PNB ~q~*~*~'/" SITE PLAN 9/6/11 DESIGN CRiTERiIA: I NUMBER OF BEDROOMS: 3 GALLONS PER DAY (GPD): 450 PERCOLATION RATE/S: 1.8 MIN/INCH PROPOSED APPLICATION RATE: 0.8 MINIMUM DRAINFIELD SQ.FT.: 563 SQ. FT. DRAINFIELD DESIGN: MAXIMUM DEPTH: 12' MAX WIDTH: 2.5' LENGTH: 2 @ 20' = 40" M.O.A. APPROVED SAND FILTER: N/A EFFECTIVE: 8' REDUCTION FACTOR: N/A ACTUAL SQ.FT.: 640 SQ. FT. / / GEG, Ltd. HAS A 7 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. / / / / / / / / / / / / NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH LOT LINE, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. / NOTE: HAVE PROFESSIONALLY FLAGGED PRIOR CONSTRUCTION. I I · EXISTING SEPTIC TANK TO\BE "DECOMISSIONED" PER UPC. DRAINFIELD TO ~3E ABANDONED IN ~LACE. \ \ \ \ I / / ? / // / ///2"HDPE W/ NO MUST BE PLACED IN CONDUIT. SCALE: I GARiN'ESS ENGIN'EERING GROUP, :Ltd. ~' :;';~;~:'~;~ CONSULTANTS & GENERAL CI TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 * PHONE (907)~7-6179 * FAX (907),338-3246 * WEBSITE: www.gamessengineering.corn THE CONTRACTOR SHALL THE WATER LINE LOCATED & TO STARTING PREPARED FOR: I PHONE NUMBER: I PaGE NUMBER: ELIZABETH GOODRICH I 346-1453 I 2 OF 2 LEGAL DESCRIPTION: I DRAWN BY: LAKEWOOD HILLS #4; BLOCK 1, LOT 7 I PNB OF WORK: I91DATE:/6/1 1 SEPTIC DESIGN UPGRADE 24" DIAMETER ORENCO PUMP VAULT WITH 2" SLUDGE TRANSFER PUMP & ORENCO CONTROL PANEL. PROVIDE HIGH LEVEL ALARM IN HOUSE. PUMP VAULT SHALL BE LOCATED GREATER THAN 10 FEET FROM THE WATER SERVICE LINE. EXISTING BEDROOM TH#I / 1250 l~ GALLON SEPTIC TANK /~ DRL C/O'S & FLOW SPLITTER. PROPOSED DRAINFIELDS 20' LONG EACH GARNESS .ENGINEERING GROUP, [SOIL LOG - PERCOLATION TEST[ ORGANICS TESTHOLE ffl [ MIXTURE OF GM & SM MATERIAL. SOIL CLASSIFICATIONS GW ~ ORG GP ifiL OH GL GC OL SW IfiH SP CH Sift OH SC DEPTH TO GROUNDWATER DATE DRY 8/27/11 DRY 8/29/11 DRY 9/1/11 DRY 9/6/11 \ / LAKEWOOD HILLS #4; // BLOCK 1, LOT 6 / \ DATE READING CLOCK TIHE NET TlifiE (PIlNUTES) WATER LEVEL READING NET DROP (INCHES) 0.50" 9/1/11 1 11:35 - 6.00" - 2 11:4,3 10 0.00" 5.50" 3 11:44 - 6.00" - 4 11:54 10 0.50" 5.50" 5 11:54 - 6.00" - 6 12:04 10 5.50" 7 12:04 - 6.00" - 8 12:14 10 0.50" 5.50" 9 12:14 - 6.00" - 10 12:24 10 0.50" 5.50" 11 12:24 - 6.00" - 12 12:34 10 0.50" 5.50" SOILS LOGGED BY: COIfiHENTS'.: PERFORMED BY GEG, Ltd. I, ,JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ~/~/ll 7=! PERCOLATION RATE 1.81 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES TEST RUN BETWEEN 5.5 FT. AND 6.5 FT. A FOUR HOUR PRESOAK WAS PERFORMED: [] YES [] NO ROB CAMPBELL PERCOLATION TEST PERFO~HED BY: ROB CAMPBELL IN ACCORDANCE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION \ "~ ,- ENVIRONMENTAL ENGINEERING DIVISION ~; 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ; i~" ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~./..~ [] NEW NAME C~ ~ ¢~C'-~ ~ g $ ~ '~-~ ~ .-[~'19~GRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF B~DROOMS Well Absorption area Dwelling PERM T NO. DISTANOETO: 10~ ~' Materia I % Manufacturer ~ No, of ~om~artme~ts Width DISTANCE TO: Manufacturer DISTANCE TO: No. of lines Length Type of crib DISTANCE TO: Class DISTANCE TO: IF HOMEMADE: Inside lengtl~ Dwelling Liquid depth PERMIT NO. Material Liquid capacity in gallons Foundation Nearest lot line PERMIT NO. Total length of lines Trench width Distance between lines inches Material beneath tile Total effective absorption area Depth inches PERMIT NO, Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO, Sewer line Septic tank Absorpt on area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS ./ ~ % APPROVED q, %,,',y:, ..~ .;, .: .-.: 72-013 (Rev. 3/78) LEGAL ;.:', 6 4.--. zt. '7 ;::.'. 0 GREA.,ER ANCHORAGE AREA BORC,.,GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM __ MAILING ADDRESS ~Q,'--~ ~"~-~-d~'~- *~O)~ '?,)~0 PHONE~.".)~;~ (/~'.'.'./~/ LEGAL DESCRIPTION J"* ''') gi ~2~J2~.Ax.,g._,.;.~g~) (.~..x_.~).~.. CA,C.[ INSIDE LENGTH INSIDE WIDTH __ LIQUID DEPTH LIQUID CAPACITY__ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE TOTAL LENGTH OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA -~"~f~o [ SQ. FT. LENGTH OF EACH LINE ( DEPTH OF FILTER DEPTN: TOP OF TILE TO FINISH GRADE-'~, MATERIAL BENEATH TILE'~'-"~- 4,~/. ABOVE TILE ~/ IN. WELL: ' T y p E ~'%~,~ BUILDING FOUNDATION__ CESSPOOL APPROVED CONSTRUCTION ___ NEAREST LOT LINE ___ __, OTHER SOURCES DISAPPROVED ~ //'~, DEPTH NEAREST SEPTIC SEEPAGE SEWER LINE , TANK , SYSTEM .REMARKS DISTANCE FROM: DISTANCES: .... DIAGRAM OF SYSTEM SEWER LINE DEPTH: p i p E M A T E R i A L :d-.~.~5~.-- _~'~,~,~ LOT SLOPE~_...~'~ i..E:I'.,I(iiTH [::, ]: I'"lE:l',l:i:]; :[ I:i:ll'.,I 3: S 'TI'lIE I...IENI:3't"I-I ,:: :!: l",l I;::'I;!i:IET ::, OF:' TI'Ifil i3F::' I:;:1 't'I:;i:I;:i'.,IE:II Of;il F'i[T ili'.:ii; "I"HI!;i Iii:,ili?l'l':ll',lE:liiil !i',Eii'l'l.,.l[!:iEii'.,! f::ll",l[i:, '1'1'-I1!!i li!i:EFFTEiI"I I=d:::' TI.II:~-i I'iii',:':',tiii:i:;:l',,,'f¥1"illEd',l ,:i lilt.,/ bio '.i!;E:'r' I.,.I ~1: DTH I::'Ol:;i'. f'iil:a:l:::lk,'liii:l... I:::,Ii;!:I:::'TH :[ '_':i: "l"Hlii!: I"1:1: hi I I'll..Jl"'l 17::,lEi:I-:'"l"l'.l ELF.' Gl:~:f:l'v'lii:l.. Edii:'lq.,IJEE2',l "Fl'lliii: EtLITF:'F:iI ..I.. 190TTEd"I OF= FI'IIZ E:t:'::E:f:iYf:'IT)'ii::iI'.~ ,:::lJi'..I GREATER ANCtlOI</\GL AI<J.A [$OROLJG,, L}epartment of Envirorlmenl. a] Qua Ji Ly 3330 'lC" SLreet Anchorage, A1 as ka 99503 SOII,S LOG Iq~ROI,ATION TEST I~XEG'UTIVJ~ BUILDERS~ I~C, . , , D - , R/5/7~ Perfornled for ~ c/ ;,ate ~erTor~:m,.:., ----,-- This form reports: Soils log x Percolation Les[ Depth 0. ~_e. et ..... 1 T ~--~-_, ~rk-~i~m~tre-ia! , ~.t'e ...... Oo ~ Oi~I S S i~E 2 - Brown si] t, ramdo~n rock, no s ~.'rld Si].'~ fraction non-plastic 6 7 7.5 Poorly graded,silty gravel, no clay, Silt fraction non-plastic 10 - ,-,e?o,o~- 1'1 - .Poorly 8faded, sandy gravel~ little 12- or no silt. Fines fraction non-plastic. ~' Class 1.3.Q' _~SCS "CF" 14- 20.0 Clean~ coarse sand, no silt. USGS Class "SW/SP". Wa-S"grouncl water encodfi't-qf6-d'F~. _~_~2-_._-T.__T_ 'if yes, at what depth? 'F~T&~)]-a t--i-o~ -F~i~ .............. il[i-n-uTe-. '.Proposed i ns tall a~l-~- -'B~ge Pi t Drain Fi o Jd X DepUi of Inlet .................. . Dept'lT~'b6'~'~'m%?--i)it or Lrench 7T5 COMMENTS: ..i)~;~=n~.$9.1=~- $p~v~...p_~p_0m~d.__a_~ 130 sq, ~, seepage a,~ea pe~ bedroom, .......... ~ ...... ~ ......... T~= ............. Performed [~y: / ~,~,~ -,~..~ Certified Eq-04O ~B/74) GRE/.,..ER ANCHORAGE AREA BOR Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME SEPTIC TANK: DISTANCE FROM WELL .,k'2'"4~ INSIDE LENGTH MANUFACTURER ~,,~'¢--~ MATERIAL / INSIDE WIDTH~,~____ LIQUID DEPTH  NUMBER OF COMPARTMENTS / LIQUID CAPACITY GALLONS. TILE DRAIN FIELD: / DISTANCE FROM WELL//¢~' FOUNDATION ~'~) _ NUMBER OF LINES DISTANCE BETWEEN LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH NEAREST LOT LINE__ / OF LINES TRENCH WIDTFI~ /IN. TOTAL EFFECTIVE / FT. LENGTH OF EACH LINE ~--0 / DEPTH OF FILTER~ MATERIAL BENEATH TILE ~ IN. ABOVE TILE ~¢ IN. WELL: TYPE BUILDING FOUNDATION__ CESSPOOL APPROVED CONSTRUCTION NEAREST NEAREST LOT LINE__, SEWER LINE OTHER SOURCES__. DISAPPROVED REMARKS DEPTH I SEPTIC SEEPAGE TANK__ SYSTEM DISTANCE FROM: DISTANCES: I N STA L LED By: ~t-~ ./~.~" ~ SEWER LINE DEPTH: PIPE MATERIAL: ~-~"~ ~/" LOT SLOPE: REMARKS: Form LQ-032 DIAGRAM OF SYSTEM J~4 'W DRILLING, Inc. P. O. Box 4-1224 · 1310C International Airport Road (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner. . E×ecutive Ii, u! lc!~..,.r.~ .Use of Well ' ' ,'...:',,, Location (address of: Township, Range, Section, if known; or "distance main road, ' Lot 7~ BI]{ 1 ~~ liiJ. J s Size of casing. 6" .Depth of Hole .I00 feet Cased to 'U,)2.? feet Static water level P.,O ft. (Abqv.e.) (below) land surface. Finish of well (check one) open end ( ;.: ); Screen ( ); Perforated ( .~:, ). Describe screen or perforation ';:.J .1.~ ,q~:;..fa l-'o.~:~s,~gt..P,~')~70.'77~, z.), .TBt?O, ....... Bf~a~ :.,."' Well pumping test at 2~ gallons per (l16fi~) (minute) for ! hours with 10~ ft. of drawdown from static level. :~. .... pt~ * 9'75 · Date of completion 9 c~,, .. _ WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material color and hardness 10 ,, ~il't~; n,~d~ arave! .15 ~.O 0 TO JO TO 15 .TO 4,0 TO 414 .TO 5,q .TO 7.) .TO ~f) .TO 90 TO 91 .TO 96 .TQ 99 TO. __.TO .- TO. TO. 4'~ 9O 96 99 10,.'3. " 3--CONTRACTOR GRE! ER ANCHORAGE AREA BOb UGH PERMIT NO. DEPARTMENT OF ~NW.ONMENTA' QUA~.~TY O;::~ SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT NAME OF APPLICANT J v ~ MAILING ADDRESS(. INSTALLATION LOCATION '~--~' INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH · SOil TEST RESULTS // ..'%' (") /'~/r//'~'~'~' ? SEEPAGE PiT , DRAIN FIELD ., OTHER '2L/) NOT£, THIS PERI~IIT ,S(~OT YAI.,ID WITHOUT ~;Oli TE:S'f FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENV]RONMI~NTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ,, SEEPAGE PIT TO NEAREST LOT LINE. DRA,N F,ELO ., DRAIN " SEEPAGE PIt ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIt DRAIN FIELD ~- /wo SEPTIC TANK , SEEPAGE PIT ., DRAIN FIELD TO RIVERi LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOil. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIt FITTED With AIRTIGHT REMOVABLE CAPS, I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-08 AND THAT THE ABOVE DESCR]B SYSTEM IS IN ACCORDANCE WITH SAID CODE. / / ~' APPLICANT'S SIGNATURE /' '- (.h W/ I hereby cerli[y that I hove sur'cey .mi,' ~? foil,owing detcribod prop~rpt, Lot ?' ~ck / Improve~en~ slluated thereon are wl~ln the properly line, and do nor o~erla~ or enc~ach on ~o pmpe~ ~lng adi~ent thore~ ~a~ no Improvement~ on proper~t lying ud[ac~nl Ihere~ enc~ch on the premi~l la quesl~n ~d thai ~ere are no roa~oy~ tran~rnt~n lh~ or Municipality of Anchorage Development Services Department CERTIFICATE FOR A Building Safety Division On-Site Water & Wastewater Program .4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 OF ON-SITE SYSTEMS APPROVAL SINGLE F AHILY DWELLING 0 Parcel I.D. 015-154-25 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address LAKEWOOD HILLS #4; BLOCK 1, LOT 7 10541 ELIES DRIVE *ANCHORAGE, AK 99507 ELIZABETH GOODRICH Day phone 10541 ELIES DRIVE *ANCHORAGE, AK 99507 346-1433 Day phone STEPHEN VLAHOVlCH W/ DYNAMIC Day phone 223-5998 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by'a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. STATEMENT OF INSPECTION BY ENGINEER As certifieduy ~ my seal affixed hereto and as u,-' "-,,e 'w,u~,un-':~'= u~Le'~' shown below, / 'w,,,y investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this app#cation, sho~ that the on-site wa!er supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedroom, s and type of structure indicated herein. I further verify that based on t,he /nform,,ation obtained from the Municipality of Ancherage f~es and from m,y investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all appficable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 557-6179 Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for t,~e sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE ~/ Approved for _~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: ~,.~ .... . COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisor7 (Rev. 1 ~/05) Arsenic Adv sory Maintenance Agreements Supplemental Engineer's Report u ~1 lei Ao Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: WELL DATA LAKEWOOD HILLS #4; BLOCK 1, LOT 7 Parcel ID: 015-134-25 Well type PRIVATE Date completed '10/5/11 Total depth 114 ft. Date of test Static water level Well production WATER SAMPLE RESULTS: *OLD WELL WAS DECOMMISSIONED PER UPC. IfA, B, orC provide PWSID# N/A Sanitary seal (Y/N) YES Well Log (Y/N) YES Wires properly protected (Y/N) Cased to 114 ft. Casing height (above ground) FROM WELL LOG 1 o/3/11 84 ft. AT INSPECTION NEW WELL ft. 10 g.p.m. g.p.m Coliform 0 colonies/lO0 mi. Arsenic: ~ I~ ug./L. SEPTIC/HOLDING TANK DATA Nitrate~'O ~- mg./L. Collected by: Date of sample: *DOUBLE C/O'S PRIOR TO PUMP VAULT GEG, Ltd. Tank Type/Material SEPTIC/STEEL Date installed 9/13-14-/1 1 Tank size 1250 gal. Number of compartments 2 Cleanouts (Y/N) YES Foundation deanout (Y/N) *YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper - ABSORPTION FIELD DATA I'BELOW EXISTING GRADEI Date installed 9/15-14/11 Soil rating (g.p.d./ft2or~ 0.8 System type DUAL TRENCHES Length 2 © 20 = 40ft. Width 2.5 ft. Gravel below pipe 8.0 ff. Total depth 12.4-9+ ft. Eft. absorption area 64-0 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 4- bedrooms Fluid depth in absorption field beforetest - in. Water added - gal. New depth - in. Elapsed Time: - min. Final fluid depth - in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date - YES 24+ in. D. 24" ORENCO PUMP VAULT Date installed 9/13-14/'11 "Pump on" level at 62 in. Datum TOP OF MH LID SEPARATION DISTANCES Size in gallons 78 "Pump off" level at 79 in. Cycles tested. NEW SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ Septic tank/liE station on lot Absorption field on lot. 100'+ Public sewer main N/'A Sewer/septic service line 25'+ Animal containment areas 50'+ Manhole/Access (Y/N) YES High water alarm level at ' 58 Meets alarm & circuit requirements? Building foundation Water main Wells on adjacent lots On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/'A Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5' + Property line 5' + N/A Water service line 1 O' + 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation. 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ YES Absorption field Surface water. in. F. COMMENTS N/A 100'+ 5'+ 100'+ Water main N/'A Driveway, parking/vehicle storage 10'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date ) ~ /~/1~ COSA Fee $ c~ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elrnore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # osc 111391 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 7 of Lakewood Hills #4 subdivision. This inspection revealed a nitrate concentration of 8.02 milligrams per liter (rog/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. mm ! 0 / / i I / 10' UTILITY EASEMENT m ...q -I IT1 NOO°O3'12"W 175.00 PROSPECT HEIGHTS, ADDITION No. 4 SGS ReL# 1114938001 y"~ Client Name Gamess Engineering Group, Ltd Printed Date/Time 10/14/2011 9:04 Project Name/# Lakewood Hill~ L7 B1 Collected Date/Time 10/06/2011 16:15 Client Sample ID Lakewood Hills L7 BI Received Date/Time 10/07/2011 12:19 Matrix Drinking Water Technical Director Stel}hen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 10/11/11 10/12/11 NRB Waters Department TotalNitrate/Nitrite-N 8.02 0.100 mg/L SM204500NO3-F B (<10) 10/I0/11 AYC Microbiology Laboratory Colony Count 2 col/100mL SM20 9222B A (<200) 10/07/11 DLC Fecal Coliform 0 col/100mL SM20 9222B A (<1) 10/07/11 DLC Total Coliform 0 col/100mL SM20 9222B A (<I) 10/07/11 DLC MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~61N .PI 'F'ti~ Iq,AL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date' //Cf, 7 ) ~:¢~ 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L -7 'G / /-/lit s ;'-d'z/-1 Location (address or directions) (b) Applicant Name ~E, 0mc~so,: Applicant Address ~ ~ ¢ ~ (c) Applicant is (check one): Lending Institution ~; Owner/builder Buyer ~; Other ~ (explain); Telephone: Home &':~z~.¢ ~;,2.2zC-~"Business ? (d) Lending Institution ,~ Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 3 4 4 TYPE OF RESIDENCE Single-Family(~ Multi-Family[] Number of Bedrooms ~ 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. 4. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation of this He'alth Authority Approval shows that the on-site water supply ar,~,'or v;c, atcwc4c~ dlsposaFsystem 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 suppry waetewetcr dlspeeel system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on thedateofthisinspection,,,z.×¢er~ +--ko-cc ~'1,~ $-~p-t:,~ E,'~k ~¢~.y Io~ Eoo ~{~ ~ '~h~- Name of Firm )'h~c~cd tL/..or'~ ~ ~---~__~-- Telephone ----~'~-~'~- ' '~7 (I Address '-7 I'D..-? (]]) ~ ~-~,,~y Date ~//'7 /~ (-.¢' WATER WELL NOTE: This Health Authority Approval inspection merely certifies that the subject water well produced 150 gallons per bedroom or more on the date of testing and that certified laboratory tests showed no presence of coliform bacteria in a sample of that water. No warantee or certification is expressed or implied concerning the long term adequacy or safety of the water supply. .~'~ -'"~'~'~"~ -ON:SITE SEWAGF.~E1%~POS~,L SYSTEf~N(~TE: "~h' He~uthority Ap~ i n~ly ce~-~t_ he~~~i spo sa l date ~.~ as dete~y methods~ve~_by re~~ MOA fil~;as n erified durin¢is iffspection/ En DHEP APPROVAL Approved for ~'~edrooms by A~ed Disa~ved Terms of Conditional Approval 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 professionaJ engineer's work. Page 2 of 2 M(JNIC~PALITy OF ANCHoRA~S DEPT, Off H~ALT ENVIRONME~. .... H & MUNICIPALITY OF ANCHORAGE (MOA) , o ,'~,,~c PROTEC'rlO HEALTH AUTHORITY APPROVAL (HAA) - Co¥,~ I t~o~.~-[ ~ N CHECKLIST- FEBRUARY 1984 /1~ 7 ~! 264-4720 Legal Description: /~ "7 ~'~'~ / ~6~//'-~ ¢f'~- WELL DATA Well Classification Pr, VcJ~ -~?S/ . ~ ~L/ if A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) 7 Date Completed ~::~ [P ~ ~ ) } ~' Yield Depth of Grouting /~//~ Pump Set At (~'~ ~: ~ ~ ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) {-~/m ],~ ln,¢~O ~ ; On Adjoining Lots IO~t~ ; On Adjoining Lots IOo To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date ~/~ Total Depth ! 0 O Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole /,/ Water Sample Collected by Water Sample Test Results Comments '-)( ~',~ ¢ 0o¢__.(I SEPTIC/HOLDING TANK DATA Size /~ ~'-O No. of Compartments ~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) Date Last Pumped I O ~v r-s. /%///~ ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field Date Installed ~/7 E Standpipes (Y/N) ~ Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well g&~ ~ol,/ To Property Line / ~- To Water Main/Service Line ~O -- 2.0 To Stream, Pond, Lake, or Major Drainage Course Page 1 of 2 72-026(11184} Soils Rating in Absorption Strata j Datelnstalled ~/'~¢' ¢-.~-¢-, ~ ~ /7~...~~'''~' Width of Field ~ Cq~ f or-'te~ uare Feet of Absorption Area '¢ Depression over Field (Y/N) 5'~.~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /O O ± ~,¢1~1 Type of System Design Length of Field Depth of Field '~'f ~' Gravel Bed Thickness '"'"'- Standpipes Present'(Y/N) Date of Last Adequacy Test ;s "-'~O To Property Line To Building Foundation Lot "~ ,~O / 4- f To Water Main/Service Line ~' To Stream/Pond/Lake/or Major Drainage Course ,? To Driveway, Parking Area, or Vehicle Storage Area Comments ~'~' ¢ ¢'~ '"~-~¢~c ~gJ rm~ To Existing or Abandoned System on ; On Adjoining Lots ~'?~O / To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes ..(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comment's ** Check Permitted Bedroom Rating Against HAA Request ** I certify tha~..~ec¢¢ve~:nformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed '.,'~---'~ .~-~~ Date Company /~,¢~.~.~'~}~o,-~¢ ,~----~'.~-,-- MOA No, Receipt No. 3'7 ~'~'~ ~ Date of Payment Amount: $ Page 2 of 2 72-026 (11/84} NlunicipalitYof Anchorage P.O. BoX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOI~ DEPARTMENT OF HEALTH & HUMAN SERVICES July 2, 1986 Neil Hawthorne, P.E. NHawthorne-Engineering 7127 Old Seward Highway Anchorage, Alaska 99503 Subject: Lot 7 Block 1 Lakewood Hills Subdivision #4 Waiver Request, WR86-085 Dear Mr. Hawthorne: Your request for a waiver for the subject lot has been denied. Available information on the soils and hydrogeological conditions on the subject lot indicated that a waiver of the 100 foot separation requirement was not warranted. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw NI-IAWTHORNE-ENGINEERING June 26, 1985 Mr. Steven Morris Anchorage Dept. of Health ~ Human Services 825 L Street Anchorage, AK 99501 Re: L7 B1Lakewood Hills #4, S13, T12N, R3W 7127 OlD SEWARD HIGHWAY ANCHORAGE, ALASI~ 99502 - · OF ~x,~,_, - ~NVIRONM~NTAL-~-,,-u t PROTfiCTIoN & REC[IVE Dear Steve: This letter is a result of a conditional health authority approval on the above property and my recent site investigation. The enclosed sketch shows sewage system appurtenances and the well. We were finally able to verify pipe connections, etc. with water and a power snake. As you can see, the well is 52 feet from the septic tank. This was apparently approved in August, 1976 by your department after a second trench was installed. The previous paperwork is enclosed. The client, of course, would like a waiver for the septic tank to well separation distance. If the enclosuress don't answer all of your questions, please call. NH:ck Enclosures NlunicipahtYof Anchorage P.O. BO,,, 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES April 14, 1986 Neil Hawthorne, P.E. NHawthorne-Engineering 7127 Old Seward Highway Anchorage, Alasga 99502 Subject: Lot 7 Block 1Lakewood Hills Subdivision #4 Waiver Request, WR86-042 Dear Mr. Hawthorne: Your request for a waiver of well to septic system separation distances cannot be considered until more information is supplied. As you have stated in your request, the exact locations of the septic system components cannot be made until breakup. A conditional Health Authority Approval can be granted for the subject property under the following conditions: Funds shall be escrowed to cover the cost of relocating the well. (You have estimated this cost at~$6,000) A formal, completed waiver request for the subject property must be submitted to the department by May 15, 1986. If the waiver request is denied, relocation of the well and/or septic system componehts must be accomplished prior to July 1, 1986. Failure to comply with the conditions of the Health Authority Approval will result in its in~ediate revocation. Sincerely, Step~~en S'7 Mo r~r'is Civil Engineer On-site Services SSM/ljw NHAWTHORNE-ENGINEERING April 3, 1986 Ms. Susan Oswalt Department of Health and Human Services Municipality of Anchorage 826 L Street Anchorage, Alaska 99501 7127 OLD SEWARD HIghWAY .",.CHORALE, , 907-344-47! 1DF, PT, OF HEALTH & I]NVIP, ONMI~NTAL P~OTECTION ECEIVED RE: Lot 7 Block 1 Lakewood tlills #4, S13, T12N, R3W Dear Ms. Oswalt; This request for a separation distance waiver and a conditional health authority approval is a little different. Strange, in fact. I have gone through the file and looked at the site and still am not sure how the on-site wastewater system was built or connected (or approved). Apparently, the first tank and drainfield were installed at about the same time as the well; September, 1975. The well wasn't approved becat~se of the separation distances, so a new trench was constructed and was inspected August 31, 1976. That inspection shows the trench to be 95 feet from the well, although my measurements indicate that it may be 100 feet away. The septic tank, however, is only 53 feet or so from the well if it is still located where the original inspection showed it. There are no pipes visible at this time so we want to expose them after breakup. Due to 2 feet of snow and the frozen ground, the owner has requested that I ask for a conditional Health Authority Approval. In the worst case, I estimate that relocating the entire septic system and furnishing a new tank will cost about $6000 including engineering, assuming the 1975 soils test is fairly accurate. That price includes properly abandoning the old system, driveway repairs, etc. I can't locate all the neighboring wells and septic systems w~th the snow cover, but relocating the well instead of the septic tank may be the best choice if separation distances allow. That action would leave two full sized drainfields on the lot available for wastewater disposal. A new well and service line should cost less than the $6000 mentioned ¢~bove, and both upgrades would not be required. In other words, if the septic system is upgraded, the well will not have to be moved and vice versa. When breakup comes, I can more easily determine the exact location of the 1976 trench. As I said, it now appears to be lO0 feet from the well although the inspection report shows 95 feet. If the well remains where it is, we should probably have a waiver of 'the 100 foot distance requirement between the well and drainfield. It's possible that the drainfield is arched which I can't tell from the surface. I have included the well log for your information but you may want to wait until June to see which improvement is undertaken. Th~s./ Neil Itawthorne 'x MUNICIPALITY OF ANCHORAGE ~qVIRONM~3qTAL ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 HAY 2, ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 .RECEi /ED REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIREOTIONS~ Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing, 1, PROPERTY OWNER 1 PHONE Merrill Lynch Relocation Mortgage (Wayne Pighin MAI LING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2, BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION I PHONE I MAILING ADDRESS 4. REALTOR/AGENT I PHONE Jack White Company % Elliot LawsonJ 277-1553 MAI LING ADDR ESS 3201 C Street - Calais II 995,03 ......... 5, LEGAL DESCRIPTION Lot 7 Block 1 Lakewood Hills Subdivision #4 STREET LOCATION Elies Drive 6, TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY plus a den NUMBER OF BEDROOMS [] One [] Four ~ Two [] Five [] Three [] Six [] Other 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYS'rEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER . [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL r~ 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 []Septic Tank or E~Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: L ~-~ TYPE OF TANK MANUFACTURER 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line [] CONDITIONAL APPROVAL (letter must a/./~pany certificate) [~ DISAPPROVED .~ I/ .~.~. LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: MERRILL LYNCH RELOCATION MGT. INC. (Wayne Pighin) Mailing Address: see A~ent Info below Day Phone: 3. Name of Buyer: No buyer yet .... just 11stlng property xxxx Mailing Address: Name of Lending Institution: Mailing Address: Day Phone:. No bank yet .... just listing property Phone: 5. Name of Realtor or Agent: JACK WHITE COMPANY (Attn: ELLIOT LAWSON) Mailing Address: 3201 C Street~ Anchorage, AK Phone: 277-1553 6. Legal Description: Lot 7, Block 1, Lakewood Hills Sub. #4 Location: On Elies Drive~ just off Upper O'Malley Road .... house sits back from street .... has natural wood siding .... approx. 5th lot on right hand side of Elies Drive. 7. Type of Facility to be Inspected: Single-family 8. Water Supply Type of Supply: Public Utility. If Individual, number of dwellings presently served If Individual, depth of well unknown 9. Sewage Disposal System Type of System: If Individual, date of installation No. Bdrms, 2 plus Den(no window] XXXXX Well ,Individual One Public Utility Individual (on-site) xxxx unknown.., but home blt. in approx. 1975 or 1st part of 1976 72 003(3/76) May 1, 1979 ?:Li'''~' 't".,_~'.:, 1, .... PROPERTY, OWNER, .· , "~!.~ · . ,.,,,.'"'~;{ ~:~;'~..J-~<~., ,. , ~.-.:,:,:,,:~' ;,-. ,". '. . '!.'-. . -~. ,'~. .. ,!-.:;' _ -3'...-:., ..-,: ,?':':' ;-. ,. "' ~'::'~" Merrill Lynch Relocation Mortgage(Wayne P~ghin) ~ ,' ..... MA LNG ADDRESS ..:. .... -~'~,~,:~::~:~'.~..~ .... ' _ .1. :~,~ . _ .... ~ ~ .... , .... i ~ .. ¥?~.... :. .... .~ ~,,,~,1...~:.., - .., . ~3..,..~.~,. . . ~. .. . ..- .: , . ...~ ~..> .f . ' ~ - .,.._,..~,,~, _.. ,. - Lot 7 Bl°Ck'l La'k~W6od Hills Subdivision #4 SINGLE FAMILY RESIDENCE'_- U3 OTHER (Describe) ' 5. SEWAGE DISPOSAL - · · '. , .- .. · -. ..... · x~x iNDiViDUAL/ON.SiTE,, ;:.--... ......:.~: -,; ._.. ':3, :. :..;..', .... . .,.- /: '. PUB LIC UTI LITY' '.?':.'., '""-:. ';/.. ': ~ ;,~,.~,_., . -- - r~ HoL~ING·~ANK (~ai'n~enanc~ R~'qui~ed)- . . ~'.-. - ':-'i?' -' E~3' APPROVED FOR"'"'"'-:,.: 'BEDROOMS,'.-',' '-~"i ~ ,.,,i~ ! ~_ "~':.'-: ;":/:-:~' -CONDjTIONA~"AppROvAL (see AttaChed) ~ ' ":' · "-':~ ~x~IsAPP ROV ED ' ' ??/' ' ' -:' ~-' .- '~'/-~;~'?'~:'~( "- -,~'-,'"" '- ~':',:~ '"-' We hsve-not received the p~ping receipt in t~is office;  BY (TITLE) .... ~ . · " May 29, 197 DATE 72~14 (3/78) MUNICIPALITY OF ANOHORAGE .~ ~_.~/i~(.. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEOTION ~//~j ~,.~..~ 825 L Street - Anchorage. Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 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 PHONE (work) SANTEE, Scott A. & Rhea -' 278-4581 X281 MAILING ADDRESS SRA Box 95C Anchorage, Alaska 99509 PROPERTY RESIDENT (If different from above) PHONE NHN Elias Drive Anchorage, Alaska 2, BUYER PHONE PIGHIN, Wayne R. & Barbara T. 274-7408 MAILING ADDRESS 1300 West 7th Avenue ~Jl01 Anchorage, Alaska 99501 3, LENDING INSTITUTION I PHONE Alaska National Bank1 278-4581 MAILING ADDRESS Pouch 7-010 Calais II Anchorage, Alaska 99510 4, REALTOR/AGENT ] PHONE Grace Oakley] 277-7556 MAILING ADDRESS ~m~ali-'RealtyL ' 2458 Sprucewood Anchorage, Alaska 5. LEGAL DESCRIPTION Lot 7, Block 1, Lakewood Hills S/D STREET LOCATION NHN Elias Drive Off Upper O'Malley Road 6, TYPE OF RESIDENCE SINGLE FAMILY --I MULTIPLE FAMILY NUMBER OFBEDROOMS [] One J~] Four [] Two [] Five [] Three r~ Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drillea since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM {~ INDIVI DUAL/ON-SITE** ** f individual/on-site, give installation date f system's over two (2) years old an adequacy test is reouired [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) NiUNICIPALIT¥ OF ANC' ....... DEPT. OF Hr*t ENVIRONM!::-, .~,L ,-'. .RECEIVED THIS SIDE FOR OFFICIAL USE ONL DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECT% ~-~' INSPECTOR INSPECTOR DIRECTIONS; 1. TYPE OF RESIDENCE ~ NUMBBR OF BEDROOMS ~ SINGLE FAMILY ~ ONE ~ THREE ~ FIVE ~ OTHER ~ MULTIPLE FAM[LY ~ TWO ~ FOUR ~ SIX PERMIT NUMBER 2. WATER SUPPLY ~ INDIVIDUAL DEPTH OF WELL ~ COMMUNITY DATE DRILLED ~ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~ INDIVIDUAL/ON -SITE DATE lUSTALLfiD~ ~PUBLIC UTILITY Connection Verified INSTALLER ~eptic Tank or ~Holdin~ Tank Size: ~ 0 oD If Tank is homemade 801kS eve dimensions: TYPE OF TAN O ~ TOTAL A~SORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line ~ CO~DITIO~Ak A~BOVAk {letter must accompan~ cerdficato) ~ DISA~BOVfiD DATE BY (Title} LEGAL DESCRIPTION 72-010 (Rev. 3/78) GREATER-ANCHORAGE -AREA -BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received January 6, 1976 Time of Inspection Date of Inspection ~Jg/) ~ /~/~ REQUEST FOR APPROVAL OF ~, - INDIVIDUAL SEWER & WATER FACILITIES FOR /.kD/_/j37 ' ' Cony. ~ ]. Appr0va] requested by: First National Bank of Anchorage Mailing Address: Post Office Box 720, 99510 Phone: 2. Property Owner: E×ecutive Bmilders Phone: 4. 5. 6. V 279-4481 x 231 333-8754 Mailing Address: 8507 Peck, Anchorage Legal Description: Lot 7 Block 1 Lakewood Hills t~4 Location: Eli~s Street - Anchorage C. Construction Sewage Disposal System: A. Installed Type of facility to be inspected Single Family No. of bedrooms Well Data: Individual~O~~ 7F~?~~f A. Type Z~g~' B. Depth D. Bacterial Analysis On-site system B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank 2. Manufacturer 2. Material , Absorption area , Other contamination , Absorption area , Sewer Lines , C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchora.qe, Alaska 99503 - 274-4561 MUNiCi?ALI1Y OF ANCHORAQE DEPAR'[MENT OF HEALTH & ENVIRONMENF/kL pp, o r.}CTiON REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES *** PLEASE SEE BELOW FOR ENTRY INSTRUCTIONS Type of I nsl)ection: CMFIO VA FFIA ,J^N 6 1976 RECEIVED CONV ×× Property Owner: E×e¢.H~-~ va gl~ 1 rlpl"R Mailing Address: BSa7 ]~,~,-~-, 4~ch~rage, Alaska Day Phone 333 8754 3. Name of Buyer: Norman D. Stocks Mailing Address: P. O. Box 720 5. Name of Real(or Or Agent:_ Alaska Assbciated Realty Mailing Address: 831 B Mailing Address: c/o Ralph M. Parsons, 3201 "C" St. Day Phone 276 3868 Name or Lending Institution: The First National Bank of Anchorage Phone 279-4481 x 231 Phone 274 3556 6. Legal Description: Lot 7, Block 1, Lakewood Hills # 4 Location;. Elias Street, Anchorage, Alaska '7. Type of Facility to be inspected: 8. Water Supply Type of Sqpply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation ***The purchaser, Mr. Stocks, now occupies the property. 276-3868 to gain entry to the premises. Private Well& Septic TanJi_ No. Bdrms. 2 Individual 1 private well Individual (on-site) on site Please call him at work, EQ*037 (1/74) Page 2 of two pages - Ret st for Approval of Individual Legal Description Lot 7 Block 1 Lakewood Hills ~4 ~r & Water Facilities / , Approve~ Disapprove Date ,.~-~//~../~2~ Approval ~Valid for one year from date sign~/ ' Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM c'ertify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 2~4~4561 .4.t D]EPT. O~ ~N¥1RONM~NT~L CONSER¥~kT~ON SOUTHCEIVTRAL REDIONA{_ OFF/CE JAY S. HAMMOND, Governor /r 338 DENALI STREET MACKA Y gUI L DING- ROOM'~flO: ANCHORAGE 99501 February 4, 1976 Mr. Ro].f Strickland Chief Sanitarian Anchorage Municipality 2510 E. Tudor Road Anchorage, AK 99507 Subject: Lot 7, Block 4, Lakewood Hill Subdivision Dear Mr. Strickland: We have reviewed the facts on the systems on the subject property and feel we cannot approve Lhe well at the distance i~ is now loca-~ed from the problem ~ewage disposal system° Sincerely, Kyle Jo Cherry, Regional Emvironmental Supervisor K~C/sv cc: Norm Jol]y_.