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LAMPERT ESTATES BLK 1 LT 5
Onsite File #051-102-59 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191511 PID Number: 051-102-59 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name JAMES ANDERSON ABSORPTION FIELD -EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 20870 OBERG ROAD, CHUGIAK, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. LAMPERT ESTATES 1 5 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ __ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation *5'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Existing septic tank decommissioned per code. Tank insulated. *WAIVER - OSV191098 Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer JRS Drainfield CO/MT 3034 Inspector FWCS/ MNA BENCH MARK (Assumed elevation) 100 ft Inspectes: ition5` 12/5/19 12/18/19 Location and description god 3rd 4 t BOTTOM OF TRIM ON-SITE WATER AND WASTEWATER SECTION APPROVAL ® Conditional Conditional Approval: Date low AL`s A JECHAEL N. ANDERSON: Septic System Approved - Date 1 %4?00 .. No. cE seas of/o... c ' 0 " 'W `�PESS10.1 ' Note: this approval does not include well permit requirements. (rtev uo/uziiu) A—C=14.5' B—C=6.3' A—D=12.9' B—D=10.3' A—E=10.2' B—E=14.8' A—F=9.2' B—F=17.6' PID: 051-102-59 LAMPERT ESTATES BLOCK 1, LOT 5 PERMIT: OSP191511 0 S89 53'14"W 90.00' (N89 59'20"W 96;60' R) — .— —x mac= MT x I I O x �� X ,°) 0�"O i GRAVEL MT MH D/W F E 0 DF CO i D OCC D C B .5' A COVERED x ENTRY 64.0' i 0� o EXISTING ^x— LOT 6 � M 38R HOUSE N q- 24.0' pry X—X—X—X o o SHED 1 40.0' ° 16.0' O N _x 04 DECK N 24.0' 00 I1 O x N IN xI X LOT 4 1�o�F�.�?o SCALE; V = 30 PREPARED FOR: JAMES & KAREN ANDERSON LAMPERT ESTATES BLOCK 1, LOT 5 20870 OBERG ROAD, CHUGIAK, AK 99567 Michael N. Anderson, P.E. DATE: 4661 Natrona Ave. DRAWN: Anchorage, Alaska 99516 (907)727 8864/FAX: (907)345 1391 SCALE: SCALE: NTS SUPPORT,SERVICES: OF 49TH c * 01/03/202o /A MICHAEL N. ANDERSON / No. CE 9469 FWCS 11 01/03/2020e 1 /03/2020e� FESS100, ZP4 X a z > 5 a r� < G) Id tj Lx---x--x x x -X_X__,X_ -0 NOO-00 401- -'4-2�.48' R) 0 LX----X--X--X—X�� > w cn (.0 Oo c rl; cli m 0 F X ---X 0— 'Aw 41. 12,0 — -X K x X-1 (D �o °9.0' m O 0 J C) 100 00 _24 V r or; NOO'00'40"E 220,82' (2M53' R) x 30* 30' PIRC 0 WcA 11/26/19 Municipality of Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV191098 COSA#: Permit#:OSP191511 PID#: 051-102-59 Legal Description: Lampert Estates Block 1 Lot 5 Engineer: Mike N. Anderson Applicant: James & Karen Anderson Your request for a waiver of the required 10 feet horizontal separation from the septic tank to the foundation has been approved. The approved separation distance is 5.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 1 �o f Approved by:�SL`� Name of Reviewer ■■MMUwin MxMMMMKMMMxNMMMMrMMMMM0MMzMMx0MMNxMMMMNMffzMMxzKMKxMINxRMzzMisKK00MMKMK.aMI **** VARIAN C E/WAIVER REVIEW **** MUMCPAU7Y OF o Development Services Department X� On -Site Water & Wastewater Section Parcel I.D. 051-102-59 AHCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) JAMES & KAREN ANDERSON Mailing address PO BOX 670721, CHUGIAK, AK 99567 Site address 20870 OBERG ROAD, CHUGIAK, AK 99567 Phone: 907-343-7904 Fax: 907-343-7997 Day phone 9074412097 Legal description (Sub'd., Block & Lot) LAMPERT ESTATES 131, L5 Legal description (Township, Range & Section) Lot Size 19,846 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: 0 all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ElUpgrade 0 Duplex (D) F]Holding Tank ❑ Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION A WAIVER REQUEST FOR: INCLUDES &P -Hc 4-D Distance: 1 certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: (.,2 Permit No. 15-11 Waiver Fees: 0? 5 Date of Payment: 1(/,g(, Receipt Number: 5 L 9 5 D Waiver No. O S V 19 1 0 °) � GADevelopment Services\Building Safety\On Site Water and Wastewatefforms\Client FormsTermit Application.doc Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 / Fax 345 -1391 Support Services Brent M. Western 907-440-4601 November 14, 2019 On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: LAMPERT ESTATES BLOCK 1, LOT 5 The owner has requested we proceed forward to obtain a septic permit to upgrade the aged septic tank on the subject lot. The proposed upgrade will serve the existing 3- bedroom house. Due to lot restraints and adjacent wells, the proposed tank will be reinstalled in the same location as the existing tank. The tank will be 5+ from the foundation. There has been no known adverse impacts or issues with the existing tank and the foundation. The proposed tank material is HDPE and therefore a tank collapse would be unlikely and if so would have minimal impact to the foundation based on the history, in situ SM soils and the required HDPE tank bedding material. Also, it is expected that the top of the tank will be above the toe of the footer and outside the foundation soil-bearing prism. We therefore request a waiver of tank to foundation of 5. The lot and area are served by private water. The proposed design will not impact any of the neighboring properties due to the lot layout. Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191511, Rebecca Carroll, 11/26/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191511, Rebecca Carroll, 11/26/19 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 NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION Well DISTANCE TO: P. ~ Ma ~ufacture..~''~¢ ~ ~- Liq DISTANCE TO: IF ROMEMADE: Well DISTANCE TO: No. of lines line Top of tile to finish grade Width }e of crib Crib diameter Inside length Dwelling Well Foundation Total length of lines Material beaeath tile Depth Crib dep. t h B uildin~u nd~ti~ DISTANCE TO: Driller Distance to lot line PERMIT NO, DISTANCE TO: Building foundation Sewer line Septic tank A )solpt on area(s) NO, OF BEDROOMS ~ PER~ IT NO~, No, of con~partments Liquid depth PERMIT NO, Material Liquid capacity in gallons ] ~lot line PERMIT NO. / ~ ~ Distance between lines inches Total effective absorption area inches Total effective absorption area /~'/~ ~ Nearest lot [ine/~ OTHER PIPE MATERIALS SOIL TEST RATING F(~/- INSTALLER REMARKS 3/78) DATE LEGAL Drilli g by DOC Co, dba SULLIVAN WATER WELLS P.O. BOX272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759 OWNER OF LAND ADDRESS ~ i~i: / LEGAL DESCRIPTION DATE-Started :' , PERMIT NUMBER Ended / ~ ,' ' ~ DEPTH OF WELL ,,' ':: ;," /': STATIC LEVEL OF WATER FT. ., DRAW DOWN .FT. GALS. PER HR r '';~''~ ' ~ KIND OF FORMATION: From : ~ Ft. to: ! Ft. Frmn ' Ft. to / -~,~ Ft. From/.::: ~: Ft. to ,1,:'~ ,. Ft. From /:~: d Ft. to / ,'( ii Ft. From / / ~ Ft. to ~',,~ Ft. From Ft. to ,Ft. From___Ft. to__Ft. From__Ft. to Ft. From____Ft. to Ft. From____Ft. to Ft. From Ft. to.__Ft. From Ft. to Ft. From Ft. to Ft From Ft. to.__Ft From__Ft. to.__Ft. From__Ft. to.__Ft. From Ft. to Ft e'"/'"-/i' ':'? "¥" ~' ~':'" ' From__ .'~ :,,'~. ', MJ : % ,~/. 45 :.:: ,~ From ': '"~ / ;:::~:'. From From From From From From_ From From From From From From Ft. to Ft. Ft. to_ Ft Ft. to__Ft. Ft. to Ft __Ft. to___Ft ____Ft. to Ft __Ft. to Ft. Ft. to.__Ft. Ft. to.__Ft Ft. to_ Ft. Ft. to Ft. Ft. to _Ft. Ft. to Ft. Ft. to_ Ft. __~Ft. to .Ft. MI~. I~cdPALITY OFF~NCHORAGE' DEPT. OF HEAL[H & EF~It%)NME NTAIF[ROT ECTION MISCL. INFORMATION: NOV I 8 1981 RECEIVED DRILLER'S NAME '4J::I::.::TI'"II.H h,IL.IHD[~:F..'. CF' E:E:[)I~:C~CJHE: .':.:; 2 THE: [...F.::r-,tGTH E:,:[ r,'IENE'; I Oh,! :I: iU "['PIE: LE:NGTH ,:: ;[t'.,1 I::'E:E:"[' ::, OF THE: 'T'Fi:EEI'.,!OIq OF'-': E:,F:I::t !' NF' :i:!!~:L.[::,. "F,LIE~ E:,E::PTH OF FI TF'.[£1",IC':H OF~: F'I'T' ]::'!i; THE£ [.':' :I: ii2:TFtlqC:E:: DE:'T'I.,.IE/E:N 'r'HEi: :~LIt~'.F:'F:IC:E: Cfi:' 'YFIEi: GF;~OI..Jf.,IC, I.':I1'.,t[::~ 'T'H[F.: .E,'OTTOFI OF 'THE: E::.::C:I::I'v'FIT.[Oi'.J ,::ZF] F:'E::ET::,. '!-'klE IE~iD]F;I',/EL [)E::F'TH !].~: THE I'"IINI!"ILIH E:,EEF'TH ElF' laN[::, THE DCrT"l"Or,i OF' THE: [~:]::.::C:I::!~v'i:::iT .1: CiI'.,I ,:] I I",J F:'[:EE~:T M. :[ I",! ]: HUH [:.', I :L:,'t"FINCE DE:"I'I.,.1E:E~F,! FI !.,.!E:LL.. FIND I::li",!~'r :101:3 F'E[ET !::'OF?. Fl F'F:i',,,'Iq'T'E: t.,.IE:LL OR ::LEi~21 '1'O 2tE. E~ F'E.:E'.T F:'RChH l::i F'UE~I_.IC .L,.tE:L.I... C,!:~:I::'E:HE:,]:r.,!E!~ I...tF:'O.I'.,I q"Fl[~ T'./F'[:~ CJI::' F:'LIEJL :[ C: H[.~:L.I.... H ]: I'.,! :1: Fll..Jt',l [.':, .T :E;TFI!'.,!C:E: I::'Fb::'fl','t F! 1::'[~: I 'v'I::FT'[:~: k!F~L.L 'TO FI F'P:: I ',,,'FITE.: S:;E:klE:~:;?. L :[ i'.,!E: Z ~.~; ;2.~'i F'IEET FINE:, TO I:::I COHI',iUi'..f:[T'.r' :~::E'!.,.IE:t:;:: L.:[f.,tE:: :[~; ?tS F'[.:.'F~.T. kiE:L.L LO6i:L.: FIF'.E: [~'.[:Z.[i:!L.I:[I:;~:I:.::D FIf..!E:, r,'!LtE;T EJE: F~:[!7['LIF~f.,!E:[)TO i.')F TI-tEl: HE:LL. CCIHF'I...E:T :[ CF['F!I.~;:Fi: F~'.EC~:d..J .T. '~t[EP'i[ENT'.'5 HF!'.r' I:::t!::'I:::'L.'~.'. '.'::':F'EC: :[ F F%'F:!.'I:L.I::~BLE TO II'.~-:;t..ll'q:E F'RCJPE:F: tN'.:~!;TFIL. LI::FI'IOi'.,!. I CE::t':~:'T:E!::".r' ']'I'"IFF[' ::L: I F!P1 F:Fff'I ]: L :[ FIR FI:E"I'H THE: I:,:".E:E:!LI:EFi:EHENT:5 F'OF:'. or.,I-.4L:;]:TL:: ::'.:;!?:l.,.l[El~i::i.:, F:INI::, I.qE:I...L.~5 FI'.:~; E;Ih~::'T' I::'OI:~:TH E',"r' TH[ii: I'"II.jI'.,I:[C:IPI:::II...IT'.P ::i:: ): t,.t:[LL.. :t.'N~;TFIL.L.. THE: ::.::: :[ L.II",I[::,Ei:R:E;TI::II'.,![::, TI'"I6'Ff' THE OI",I-'"::5ITE !SEI.,.I[::'F:'. '.'i~;"/:L:;'I"E:M HFI"r' Fi:[~E:!IJIF,~:E: iCHL.FIF?.C-iE:'H.C?.I'.,FT' :[I:::' THI.E F'~:I:E!'~i; ! E." l.::.~ [",l l::: !::': :l: E; [;]:[EMCII:::,E:L...F...I:::, 'I-E:! ]: I'.,tC:[..I_t[)E: O & E ENG,NEERING & DEVELOF,vlENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694~2774 SOIL LOG 688-228o Performed for: Name:_ -~ '/-~L/~A/ Z, ,..~',/<~/~c'5~ ~ ~ ~;'dP~5 )~.. Tel. No. ~'~ / Mailing Address: ~ ~D. ~ ~x' ~'/'1~>//~1~/ ~, ~'~ ~ Legal Description: ~'r ~. /~Z~/~ / / ~_~.~/o~ r)epth (teet) 0 7__ 8__ 9 10 M__ Soil Characteristics [3 I~ 72 / PLOT PLAN 12__ 13__ 14__ 15__ 16__ Ground Water Encountered: Yes Proposed Installation: Comments: /-/ No If yes, what depth Seepage Pit Drain Field__ PERC. TEST Performed by: COSA Checklist Legal Description: LAMPERT ESTATES BLOCK 1, LOT 5 Parcel ID: 051-102-59 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 10/12/1981 Total depth 181 ft Cased to 181 ft (Assumed per well log) Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 11/4/2019 Static water level at beginning of test 164 ft. Well production at time of test 4 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.888 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample 8/11/2020 Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) <1 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW Standpipes/foundation cleanout per record drawing Date of pumping NA - NEW C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 11/16/1981 ALL standpipes present per record drawing Total measured depth from grade 5.5 ft (max) Measured depth to pipe invert from grade *4.5 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective *PER MEASUREMENTS – 1’ ED. Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date 11/4/2019 Results Pass For 3 bedrooms Fluid depth prior to test 7 in Water added 600 gal New depth 9 in Elapsed time 1260 min Final fluid depth 7 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies:.*Per elevation measurements (tank outlet invert & MT). Field showing its 39 year age. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No 5+ ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No *0 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS *WR90083 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. 8/25/2020 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) ~,o5' '70 o' /3~/~(;, Property owner Mailing address Lending agency Mailin. g address_ Day phone Day phone Address Day phone. /;), v ~;,'L //*c Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ll21 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 of this Health Authority Approval application 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. S &S ENGINEERING Name of Firm Address Eagle River, Alaska 995,7 Engineer's signature Phone Date DHHS SIGNATURE Approved for -'/-/-~/~ ~ ~F bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additione: Comments By: /// / The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. 72-O25(Re~.1/91) Back MOA~I Municipality of Anchorage 0C't' ~ ~ t~.~ ~ DEPARTMENT OF HEALTH & HUMAN SER,VJf;ES ............ ... ,~ Environmental Sen/ices Division ,:';~~ ~,wc~s ~v~s~r:, 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: LoT- ~'- ~ z.~ c.~¢ t L~4~p,~/~ 7- ~£7'. Parcel I.D.: A. WELL DATA Well type Log present(~/N) "/~ Total depth Sanitary seal If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG Io/ /~-/~'1 g.p.m. Date of test Static water level ! ,~ Well production WATER SAMPLE RESULTS: Coliform O Date of sample: B, SEPTIC/HOLDING TANK DATA Date installed ] ~ / / ¢ [ ~' ! Tank size Foundation cleanout (Y/[~ Date of Pumping" C. ABSORPTION FIELD DATA Date installed Length LC'~ '/~- ' Width · Cas ng height (above ground) Wires properly protected C/N) AT INSPECTION Nitrate o '~H I Other bacteria g.p.m. Collected by: S & S ENGINEERING l/U;fq. I:.agle River Loop Road No. 204 Eagle Riveh Alaska ~9577 1oo0 Number of Compartments ~')" Cleanouts(~/N) Depression (Y/~ ~v o High water alarm (Y~) /v ¢ Pumper 4 /~ ~ Soil rating (g.p.d./ff' o;~f~ ;.3~ ~- //'30 Gravel thickness below pipe System type g _ Total depth Effective absorption area 16 ~/0 ~r'z Monitoring Tube present ((~'N) Y~J' Depression over field (Y~ /" o Date of adequacy test / r)/, ~i / ~ ~¢ Results P~/Fail) /ce ~-"f For -~ .bedrooms Fluid depth in absorption field before test (in.); O A. ¥ Immediately after ~/~(¢ gal. water added (in.): B '/), "'_ Fluid depth 3 't,/ ~' . (ins) Minutes later: A. ,-/ Absorption rate = z.j $-o -/ .g.p.d. Peroxide treatment (past 12 months) (Y/N) ~ u ,,~ ~c ~v~,~,~/ If yes, give date - 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons -------- --.. Manhole/Access (Y/N) "Pump on" level at* ~,....,~level at* High water alarm level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / 0 Absorption field on lot On adjacent lots On adjacent lots r Public sewer main Sewer/septic service line ~' ~- ~- Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~- ' q- Property line ~ '/- Absorption field Water main/service line /o ~- Surface water/drainage / o o -~ Wells on adjacent lots Public sewer manhole/cleanout ?oo -/- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain Building foundation / o Water main/service line Driveway, parking/vehicle storage area ~<,J0 ,,~ Wells on adjacent lots too F. ENGINEER'S CERTIFICATION ~.~'~. OF I ce~i~ that l have datelined thru field inspections and review of Municipal~ that theR~o~tems are Signature ' a~ ~ EOSE~ C COWAN~ ~,~ Date ' Date of Payrnent ~/~/~-~-/' ~~q Receipt Number ~ V~ ~ C~7 ~..h 72-026 (Rev, 3/96)* Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 htlp://www.cianchorage.ak.us October 28, 1998 Robert C. Cowan, P.E., S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot '5 Block 1Lampert Estates Waiver Request #WR980083, PID #051-102-59, HA980382 Dear Mr. Cowan: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 0 feet from the absorption field to the north property line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Jeffrey W. Poet Engineering Tech On-site Services ljw #7 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR#~~ PID# 051-102-59 HA~ HA980382 Date Received: October 27, 1998 Legal Description: Lot 5 Block 1 Lampert Estates Engineer: Robert C. Cowan, P.E., S & S Engineering Applicant: Permit 17034 Eagle River.,Loop Road, Suite 204, Eagle River~ Alaska Mike Reid 99577 Waiver Requested: line of 0 feet. Lot line waiver of the absorption field to the north property Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Date: /O'~q~ By: Rec ~: 04259/6582 JX2aount: $ 115,00 ~/of R~viewer Date Paid: 10'27-98 ROBERT C. COWAN, P.E. HEALTH AUTHORITY APPROVALS S EWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE W&STEWATER DISPOSALSYSTEM DESIGN October 26, 1998 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 N':',!NICIPALITY OF ANCHOILAGE D~'partment of Health and ][tuman Services P [). Box 196650 Anchorage, AK 99519 RI'FERENCE: Lot 5, Block l, Lampert Estates RECEIVED OCT 2 7 1991t Municipality of Aachorage Dept. Health & Human Services Request you issue a tfealth Authority Approval on the referenced property and grant a xvaiver for the separation distance between leachfield and the north property line at 0 feet. We do not anticipate any adverse effect on the adjacent If )ou require additional information, please contact us. Sim:erdy, l>,obert C. Cowan, P.E. RCC/skh 17034 NORTH EAGLE RIVER LOOP · SUITE 204 o EAGLE RIVER, ALASKA 99577 CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sample Remarks: 986011002 S & S Engineering N/A Lt 5 Blk 1 Lampert Est. Drinking Water Client PO// Printed Date/Time 10/17/98 16:55 Collected Date/Time 10/14/98 16:15 Received Date/Time 10/15/98 11:00 Technigal Director: Stephen C. Ede Released By~/~ ff~ ~~ ResuLts PQL Units Hethod Limits Oate Dste Init Total CoLiform 0 cot/lOO~L S;416 9~22B 10/15/98 RMV Nitrste-N 0.441 0.100 mg/L EPA 300.0 10 max 10/15/98 10/15/98 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 5; Block 1; Lampert Estates, Peters Creek Location (site address or directions) 2n870 ©berg Road Peters Creek, Alaska Property owner Mailing address Lending agency Mailing address Agent Address Judy Sprague Day phone hm. 688-9282 Wk. 562-6648 2OR70 oh~g ~oa~ ¢~m~gi~k~ A!ask~ 99567 Day phone Day phone 2;. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: · Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well xxx Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: XXX Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 of this Health Authority Approval application 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 verifythat based on the information obtained from the Municipality of Anchorage files and from my inves_ti_gation 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. Phone .~4'?/;~'/IA '~ ¢;7 ¢ Name of Firm S & S ENGINEERING Address Engineer's DHHS SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: ' I /' ' . [ Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. 72-025 (Rev. 1/91) Back MOAf~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~.-.-c,-v ~" t'~-~,~- \ ~.--/:'m"-~P E.C~.'r- Parcel I.D. ~__~--~ -¢-. Well Data Well type 1~¢...\.,.) ¢~.,¢-¢.... If A, B, or C, attach ADEC letter. ADEC water system number Log present(~N) '~ Date completed \©,-' \?-~¢~ ~ Driller Total depth \;~ \ O,¢ Oased to "~ ~ J¢ Oasing height Sanitary sea (Y~q) '-¢ Wires properly protected ~)N) -,/ FROM WELL LOG AT INSPECTION Date of test ~ ~ ~¢ ~ ~ ~ ~ ~ ~ Static water level ~ ~t ~ ~ ~ Well flow ~ ~ ~ g.p.m. ~ %'F g.p.m. Pump level1 ~ ~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot ~ ,-~ ~' Public sewer main ~\ ~ Sewer service line .~..,~ t.,,.-.~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform d Nitrate Date of sample: B. SEPTIC/HOLDINQ TANK DATA Date installed \ c'1 ~ \ Cleanouts (~YN) ',..( High water alarm (Y,~ Date of pumping Collected by: Other bacteria Tank size \ ~ ~ ~ Compartments Foundation cleanout (Y~I.~ r-[ .Depression (~/~-~ Alarm tested (y/l~ ~' ~ Pumper :~¢-, (-~se~) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface wateddrainage 72-026 (3/93)' Front On adjacent lots Absorption field Foundation Water main/service line CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manufacturer Manhole/Access (Y/N) Vent (Y/N) High water alarm level Meets MOA electric~ S~STANCE FROM LIFT STATION TO: Well on lot On adjacent lots "Pump on" level at _~at .~~Cyo es tested Surface water D. ABSORPTION FIELD DATA Date installed \,~ ~' t Length ~ \ Width Total absorption area \ L~ ~:~ Date of adequacy test \ ~ ¢ Water level in absorption field before test Peroxide treatment (past 12 months) (Y~) Soil rating (GPD/Ft2) '~ ~ ~'~ ~ l'~ .System type ~ "~P'~ ' Gravel thickness ~ ~ ~ Total depth Cleanout present'N) v/ Depression over field (Y~ Result~fail) ¢~% for ~ Bedrooms ~ ~ After test ~' ~ '=' "~ ~ ~ ~ ~( If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~. ~..~ To building foundation On adjacent lots Surface water Curtain drain \¥~ On adjacent lots ~, o O Property line \ c> ~ To existing or abandoned system on lot Cutbank ~ (' ~ Water main/service line ~ ~ Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOAand-[2~ guidelines in effect o[~:th~!date'~¢~ inspection. Signature ...................... ;/.,,..z, ./- ii i , , Eagle River, Alaska 99577 ~'~ :::,, ~,~':~:::::~,~::,:: ~'.-','.~,:~ ,; ,~ ~.' Engineers Name ~ / ~ Date ~ /~ / ~.~,:~ ~,~..',7;~.,,~ .... HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number 1071179G 16:42 C:TS, E ENUIRONI1EN]'AL LF~B SERUIC:ES NO, 2E,? [~12 COMMERCIAL. TESTING & ENGINEERING CO. ENVIRONMENTAL L, AI'3ORATOFIY .SERVICES Chemlab Ref.~ ~93.53t7-3 REPORT of ANA[.YS%S 563333 S STREET ANOHORAGE. AK 99518 TEL ¢907) 562.234.1 Client Sample ID :L5 B1 [~,~JP~B? ES?, Matrix :WATER Client Name :S & S ENGINB~iRING Ordered By tR. $HAFE~ Project Name : ProJect~ ~ PWSID : UA Sample Remarks: ROUTINE SAMPLE CO[,LCCTBD BY: RAY, FAX i907/ ¢6%.530t WORK Order :71834 Re~ort. Completed Collected :10/04/93 O [~:40 hfs Received ~10/06/9B @ 15:30 hfs Technical Direct. ortSTE~P~EN~C. EDE. Re lea~e~ By : /~_' QC &llowable Ext, gnal Parameter Results Qual unit~ Method Limits Date Bate Ini~ Nitrate-N 0.25 f~g/l, ~A 353.2/300,0 10 i0/08 CMF '* See Special Inst, ruct~.ons Above *'* See Sal~ple Remarks Above NA = Not ~nalyze~ U = Undetected, Re~rted value i~ the practical quantificat~on limit, LT = Le~ Than D = Secondary ¢ilutio~, 6T = 6rearer Than --ENVIRONMENTAL SEClVICE$ IN ALASKA, COLORAOO, UrAH, ILLiNOiS, OHIO, tSAP, YLA,~!D, WE~;T VIRGIHIA, NBW JERSEY, SOOTH CAROLINA INSPECTION A?POINTME NTS 'rIME DATE INSPECTOR TIME DATE INSPECTOR RECEIVED TIME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION [125 L Straet. Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Cornulete all paris on puqe ], Incomplete requests will not be processed. ['lease allow ten (10) davs for processing. 1. PROPERTY 2 Bt YER MAll.lNG ADDFIEGG 4 REAI.TOR/AGENT MAI LING ADDRESS PHONE ONE PHONE ar. LEGAL DESCRIPTION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ~ SINGLE FAMILY [] One [] Four [] Two ~] Five E_-J MULTIPLE FAMILY [,,~' Three ~.J Six [] Other 7, WATER SUPPLY /~ INDIVIDtJAL* COMMUNITY [] PtJl31_lC UTILITY ATTACH WELL LOG. A well log is required for all wells drilled since Juno 1975. For wel s drilled prior to that date, give well depl:h (attach log if available.) 8. SEWAGE DISPOSAl_ SYSTEM E~Y INDIVIDtJALION-SI'¥E'" /¢'¢'~J:Z.,).--YEAR ON-SITE SYSTEM WAS INSTALLED. ~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITI/~TED. 72 010 ~Rev. 6/79) 'f'NIS SID[" FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE [_] SINGLE FAMILY [-] MU L.TIPLE FAMI/.Y 2, WATER SUPPI..Y E_] INDIVIDIJAL F_] COMMUNITY []] PUBLIC UTILITY Connection Veri fled NUMBER OF BEDROOMS ['] ()NE E~J TFtREE L-] FIVE E] TWO [] FOUR [] SIX PERMIT NUMBER DEP'i"H OE WELL '~[~-F_- DRILLED ,.et, ,~C~VED 3. SEWAGE DISPOSAL SYSTEM F_] IN DIVI DUAL/ON -SITE L-:J PUBLIC UTILITY Conuection Verified .......... IINS'FALI_ER ,_;Snl)tm Tank or L] Holding Tank Size:- ~2_~52__.~_' ___ If Tank is homemade give dimensions: ................. TYPE OFTANK TO'f AL ABSORPTION AREA PERMIT NUMI~ER DATE INSTALLED SOILS RA11NG MANUFACTURER MATERIAL .,~ Septic/Holding Tank [Absorption Area ISewer Line 4. DISTANCES ' WELL TO: Absorp[ion Area to nearest Lot Line [] OTHER lNearest Lot Line 5. COMMENTS f]]] APPROVED FOR .......... BEDROOMS [_-] CONDITIONAL APPROVAL {letter must accompany certificate) 1-] DISAPPROVED DATE BY 72-010 (Rev. 6/79) EXCAVATION ROBERTA. SHAFER WORK CIVIL ENGINEER 694-2979 December 30, 1981 Ned Severson SR Box 1020 Chugiak, Alaska 99567 Dear Mr. Severson, Reference: Lot 5; Block 1; Lampert Estates The following inspections were performed by this office on December 28, 1981. (A) The on-site sewage disposal system installed by Skaggs Construction Company and inspected by this office on November 16, 1981. (B) The prJ. vate well serving the referenced property° Depressions in the earth around the septic tank and over the seepage bed were noted. Also a cap needed to be installed to seal the clean-out for the seepage bed. There were no visual discrepancies with the well. The casing appeared to be adequately sealed and ali. wiring was contained with-in conduit. The fill around the well casing was adequately graded° Re-inspection of the above noted deficiencies was made on December 30, 1981. Ail deficiencies had been corrected satisfactorily. A water sample was taken on December 28, ]_981 and analyzed by Chemical and Geological Laboratories of Anchorage and proved to be satisfactory. Based upon the above inspections, it can be concluded that these systems are currently adequate. However they cannot be guaranteed against subsequent failures. If we may be of further service, please do not hesitate to callo S ince~f~.l¥, cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA