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HomeMy WebLinkAboutLILAC PARK BLK 2 LT 3Lilac Park Block 2 Lot 3 #015-211-27 Municipality of Anchorage Community Development Department Page 1 of 3 On-Sfte Water & Wastewater Program 4700 Elmore St. a P.O. Box 196650 Anchorage, AK 99519-6650 • httpl/www.muni.org/onsite • (907)343-7904 ONSITE WASTEWATER INSPECTION REPORT Permit Number: OSP131238 PID Number: 015-211-27 ❑ New ®Upgrade Name: JIM STRATTON ABSORPTION FIELD ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 12222 LILAC CIRCLE, ANCHORAGE, AK, 99516 ❑ Other Phone: No. of Bedrooms: Sail Rating: Total Depth from original grade: (907) 349-3569 3 0.8 GPD/sq. Ft. 13.0 MAX Ft. LEGAL DESCRIPTION Depth to pipe Invert from original grade: SEE DWG. Ft. Gravel depth beneath pipe: 7.52' Ft Subdivision: LILAC PARK Block: Lot: 2 3 Fill added above original grade: Gravel length: SEE DWG. Ft 40 Ft. Township: _ Range: — Section: — Gmvel width: Beds Number of lines Distance between linea: 2.5 Ft. — Ft. SEPARATION DISTANCES Total absorption area: umber of trenches: Dist. between trenches: To Septic Absorption Lift Holding Public/Private 601 1 15' TO Ft From Tank Field Station Tank Sewer Lines .6 50. Ft RESERVE SITE well too'+ 100'+ — — 25'+ TANK ■ Septic ❑ S.T.E.P. OHolding ❑Other Manufacturer: capacity: Surface water 100'+ 100'+ — — ANCHORAGE TANK 1000 Cal. Lot Line 5'+ 10'+ — — N/A Matedol: STEEL Number of comportments: 2 Foundation 5'+ 10'+ - - LIFT STATION Curtain Drain NONE KNOWN c Manufacturer.c Gal. Remarks: 'Pump an' level at"Pump off' I High water alarm at: OLD SEPTIC TANK ABANDONED PER UPC Pump Make & FJectrical Inspections parfoI by: PIPE MATERIAL House to tank EXISTING Tank to 03034 drainfield Installer A+ HOME SERVICES Drainfield D3034 CO MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft Inspection Location and Descriplion: Dates: 1st 8/29/13 2nd 8/30/13 3rd 8 30 13 4th — BOTTOM OF VERTICAL TRIM, EAST CORNER OF HOUSE Community Development Department Approval ENGINEERS SEAL Conditional approval: Date: D��oQ .... ... ..............� .... ..... ... Y ess;. O Q 9i CE19 113 iQ �4d �e Approved:J Dater 4� dProfeseioV1 ��DO000�� PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: — OSP131238 015-211-27 A I B I C \ STI 68.37 45.08 67.22 ST2 74.76 51.22 72.73 \ DBL1 77.80 54.06 75.22 DBL2 78.64 54.95 76.14 FO 79.07 55.39 76.ST C01 85.07 63.05 85.05 SHED EXISTING DRAT FIELD CO2 75.41 45.89 58.21 CONNECTED AS RESERVE SITE MT1 76.06 46.52 58.47 1 CO3107.33 80.64 97.01 MT2 107.51 80.73 96.94 - \ I SHED \ — — MT2 C0� CO3 SUMP EXISTING 3 BEDROOM HOUSE C01 FCO I IRRIGATION WELL a e• / 100' WELL RADIUS. ABANDON EXISTING TANK � P / APPROXIMATE LOCATION OF WELL, 100' WELL RADIUS WAS FLAGGED PRIOR TO .a / CONSTRUCTION, & DURING INSPECTIONS 100' SEPARATION TO ALL SEPTIC ". LOCATIONS MET. •• '^ y GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3T11 E. MMR ROOD, 5 101 NNHORME, W 99591 • PHONE (907)337-6179 • FAX (997)336-3446 1YF95RE: wM.9amenen91nwM9.can PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JIM STRATTON 907-349-3569 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: LILAC PARK S/D; BLOCK 2, LOT 3 A.J.G. TYPE OF WORK: DATE: AS -BUILT SEPTIC SYSTEM OF SEPTIC UPGRADE 9/20/2013 (Rev. 01NJ) PERMIT NUMBER: PARCEL ID NUMBER: OSP131238 AS -BUILT DRAWING 015-211-27 TOP OF TANK AT INLET = 94.84 GRADE = 99.95-99.77 f2 TOP OF TANK / AT OUTLET = 94.78 NEW 1000 GALLON INVERT OF BUNG SEPTIC TANK INVERT OF BUNG AT INLET = 94.25 AT OUTLET = 94.02 ORIGINAL GRADE CO FINAL GRADE _ 0 HIGHEST 99.23-100.85 POINT = 98.78 TH#1 FILTER FABRIC INVERT OF PIPE = 93.30 — BOTTOM OF TRENCH - 85.78 RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 79.78 (TH DRY) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3]01 E. TIOOR NOIR, AMIE 101 • NlOH FW M 99887 • PHONE (907)33)-8179 * FM (907)338-3248 • WF841f �gomse ng~n9.NNm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JIM STRATTON 907-349-3569 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: LILAC PARK S/D; BLOCK 2, LOT 3 A.J.G. TYPE OF WORK: DATE: PROFILE AS BUILT OF NEW SEPTIC SYSTEM 9/23/2013 ,H.. . ,w, OF . . . ........ ........ of e9S, A CE -79 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131238 Tax Code Number: 01521127000 Work Type: Septic Permit Effective Dates: August 08, 2013 to August 08, 2014 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: LILAC PARK Site Legal Address: LILAC PARK BLK 2 LT 3 G:2736 Owner/Address: STRATTON JIM & CHRIS 12222 LILAC CIR ANCHORAGE AK 995162258 Site Mailing Address: 12222 LILAC CIR, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 64042 Total Bedrooms: 3 N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single FamHy Dwelling Parcel I.D. 0 15-211-27 Property owner(s) JIM STRATTON Day phone 349-3569 Mailing address 12222 LILAC CIRCLE, ANCHORAGE, AK, 99516 Site address 12222 LILAC CIRCLE, ANCHORAGE, AK, 99516 Legal description (Sub'd, Block & Lot ) LILAC PARK S/D; BLOCK 2, LOT 3 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (0 all that apply) Initial ❑ Single Family (SF) Absorption Field ® 0 (w/wo ADU) Upgrade Septic Tank ® Duplex (D) ❑ Renewal El Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Date of Payment: Receipt Number: (Rev. 09/12) GARNESS ENGINEERING GROUP Ltd. CONSULTANTS & GENERAL CONTRACTORS July 23, 2013 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System for Lilac Park Subdivision; Block 2, Lot 3 To whom it may concern The proposed three bedroom house is served by a private well anal septic system. The septic system is in a state of failure and must be upgraded. One test hole was dug on the property. The drainfield will be designed around the 30 foot radius of this test hole. We are proposing that a new 1000 gallon septic tank and also a deep trench type drainfield be installed. 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. TRENCH DESIGN: See attached design drawing for drainfield 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 topography site plan, the average topography in the area of the proposed drainfield is relatively flat. In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely, 1 n P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log, and a page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com nI 1 , \ I \ r L PARK; / 6K 1, L LILAC PARK; BLOCK 2, LOT 5 a / O Jy \\ gas \ o \ jc I c a I \ LILAC PARK; BLOCK 2, LOST/4 / 1P T 2 I PALO; 1 L01 -1 \\ i 1 LILAC PARK; BLOCK 2, LOT 6 / I \ LILAC PARK; BKOCK 2, LOT 2 I LILAC PARK; BOCK 2, LOT 1 / S LE: GARNESS ENGINEERING GROUP, Ltd. p CONSULTANTS $, GENERAL CONTRACTOR& �••••:• 3101 E. (ODOR ROOD, SUITE 101 • MICHOR.IOE, W 99A7 • PHONE (907)137-8119 • FM (907)338-3218 • W®9RE: wRxqumemen9finerin9,com p PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JIM STRATTON 349-3569 1 OF 2 -Q —. LEGAL DESCRIPTION: DRAWNBY: O49s LILAC PARK; BLOCK 2, LOT 3 A.J.G. 0�p TYPE OF WORK: DATE: uR SITE PLAN 7/23/2013 I A ULAI I BLOCK C2, LOT 9 r�I \ fUIAC�PARK� \BLOCK2. C PARK; gL6CK Lop 7 / r I I 1 43.ig�i3. • f II/f LILAC PARK; f i LOCK 2, LOT 10 � i I / 1P T 2 I PALO; 1 L01 -1 \\ i 1 LILAC PARK; BLOCK 2, LOT 6 / I \ LILAC PARK; BKOCK 2, LOT 2 I LILAC PARK; BOCK 2, LOT 1 / S LE: GARNESS ENGINEERING GROUP, Ltd. p CONSULTANTS $, GENERAL CONTRACTOR& �••••:• 3101 E. (ODOR ROOD, SUITE 101 • MICHOR.IOE, W 99A7 • PHONE (907)137-8119 • FM (907)338-3218 • W®9RE: wRxqumemen9finerin9,com p PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JIM STRATTON 349-3569 1 OF 2 -Q —. LEGAL DESCRIPTION: DRAWNBY: O49s LILAC PARK; BLOCK 2, LOT 3 A.J.G. 0�p TYPE OF WORK: DATE: uR SITE PLAN 7/23/2013 I A ULAI I BLOCK C2, LOT 9 r�I \ fUIAC�PARK� \BLOCK2. C PARK; gL6CK Lop 7 / r I I 1 43.ig�i3. • LETTER THAT PERTAINS TO THIS DESIGN. - - - - - -- NUMBER OF BEDROOMS: 3 WELL RADIUS AND NORTH LOT LINE GALLONS PER DAY (GPD): 450TO OBTAIN A COPY OF THE LETTER FLAGGED BY A REGISTERED CONTACT GEG. BY PROCEEDING FORWARD PROFESSIONAL LAND SURVEYOR PERCOLATION RATE/S: 5.39 WITH THIS INSTALLATION, THE ENGINEER, PRIOR TO CONSTRUCTION PROPOSED APPLICATION RATE: 0.8 WELL DRILLER, CONTRACTOR AND MINIMUM DRAINFIELD SQ.FT.: 562.5 PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND DRAINFIELD DESIGN: AGREE TO ACCEPT THE TERMS AND MAXIMUM DEPTH: 13'CONDITIONS OUTLINED. . WIDTH: 2.5' \ LENGTH: 40' M.O.A. APPROVED SAND FILTER: N/A EFFECTIVE: 7.5 / REDUCTION FACTOR: N/A ACTUAL SQ.FT.: 600 \ EXISTING DRAINFIELD TO BE CONNECTED AS RESERVE SITE \ PROPOSED DRAINFIELD MT , MT C PROPOSED DOUBLE CLEANOUTS AND FLOW DIVERTER EXISTING 3 EXISTING BEDROOM HOUSE / FCO INSTALL CO IRRIGATION WELL PROPOSED 1000 GALLON SEPTIC TANK a e• t+ 100' WELL ,RADIUS' ABANDON EXISTING TANK / P N SCALE, i"=30' OF GARNESS ENGINEERING GROUP, Ltd. 49 CONSULTANTS & GENERAL CONTRACTORS ...... .. . . ........ ....... I E. WWR RM, SB 181 + MCHORk E— M 99597 + PNONE (907)337-8179 + FM (907)338-3218 + R MM- rm.9omesem,9Rue8e9com tEPARED FOR: -PHONE NUMBER: PAGE NUMBER:•••••• JIM STRATTON 907-349-3569 2 OF 2 OQnnP r Garn ss. GAL DESCRIPTION: DRAWN BY: VO s 7c� LILAC PARK S/D; BLOCK 2, LOT 3 A.J.G. Q� e .•.��� •�' �oAoO DE OF WORK: DATE:dPro fes "flo, DESIGN OF PROPOSED SEPTIC UPGRADE 7/23/2013 �Opppp000 kKe . mmol GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 5101 E I WR ROAD, SURE 101 • ANCHORAGE, AK. 99507 * PHONE: (907)337 -Gin • FAX: (907)3W-3245 • WEBS - go wen^ rir SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: LILAC PARK S/D; BLOCK 2 LOT 3 PERFORMED FOR: JIM STRATTON DATE: 7/12/2013 DEPTH_ i ORGANICS (feet) - ,. TEST HOLE #1 7 8 9 10 11 12 13 14 15 16 17 18 GM TO GW DEPTH TO DATE GROUNDWATER NET TIME SOIL CLASSIFICATIONS DRY 7/22/2013 TIME (MINUTES) READING (INCHES) 7/18/2013 1 3:45_.__- - — 3 - 2 GP 10 ML 2 3/8" - ---- - 3_ 3:55 -- --- - ---6,: -- -4 --- GM CL 4 4_ 4:05 GC OL J5 4:05_ _ --- _1 - SW __. MH '• 10 —_ ----- 5d' 7/8" --- X": - ----- SP CH ' 1 6„ _ osc SM OH READINGS 8 4:45 30 7/16" 7 8 9 10 11 12 13 14 15 16 17 18 GM TO GW DEPTH TO DATE GROUNDWATER NET TIME DRY 7/12/2013 DRY 7/22/2013 TIME (MINUTES) DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 7/18/2013 1 3:45_.__- - — - - 2 3:55_ 10 3 5/8'- - 2 3/8" - ---- - 3_ 3:55 -- --- - ---6,: -- -4 --- - - -Z„--- 4_ 4:05 10-- _ J5 4:05_ _ --- _1 - __. -- 64:15 ---7 � 10 —_ ----- 4 1/8” _ -._._ 7/8" --- ---- - ----- 4:15 - 6„ _ SWITCHED TO 30 MINUTE READINGS 8 4:45 30 7/16" 5 9/16" 9 4:45 - 6" - 10 5:15 30 7/16" 5 9/16" t.. PERCOLATION RATE 5.39 (MIN./INCH) PERC. HOLE DIA. INCHES 19 B.O.H. TEST RUN BETWEEN 6.5 FT. AND 7.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAq PE FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 7 13 %A 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 PHONE .SEW 9 W1,4` e- wl�c /r1C ❑UPGRADE MAILING ADDRESS 2077 qD G �hc,I�Ori�jP AK q9 LEGAL DESCRIPTION LG •1- 3 P /o c !c 2 T i Z { V' /z w e ` z. LOCATION NO. OF BEDROOMS J DISTANCE TO: Well /0 ✓ r -f Absorption area lrz, Dwelling �f •� PERMIT NO. P riu.:i'-� C) y 1- ZManufacturer /-1 Material No. of compartments LU F.Q. rn Lic. capacity in gallons IF HOMEMADE:4Dw'IInside length Width Liquid depth DISTANCE TO: Well ing PERMIT NO. JG Z O x? H Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well i /L 0 Foundation 62 Nearest lot line Z PERMIT NO. uWX J LL z No. of lines Length of each line Total length of lines Trench width Distance between lines Z w ,y 5 ;� CU inches o[ Top tile to finish Material beneath tile Total F. of grade Y, effective absorption area o 7Z inches G 5 Fi .a Length Width Depth PERMIT NO. Lu f7 Q F (L Type of crib Crib diameter Crib depth Total effective absorption area LU a 0 DISTANCE TO: Well Building foundation Nearest lot line � Class I_ Depth Driller Distance to lot line PERMIT NO. rr✓r7� WBuilding DISTANCE TO: foundation Sewer line / Septic tank / Absorption area(s) 0 co OTHER �' tg PIPE MATERIALS PSC r t ;t% u SOI L TEST RATING r / 3 INSTALLER Ampe °/ /a.� A REMARKS '�'� �, >�t �ucava/ar w�'ry /�siu{/ �urr�drLL�,,fi•�, c. �. L'/C7ie�— %70[.i•L in S'P.".%k7 'Cl� ^^ cJnDrc/I C>! •P CCS R.- 1 APPROVED 'i;?C < DATE LEGAL (+ F % { Z /v 9 rtJ d -cc 2.-"L• �.�7�J1�/Fi�� /-20 %Par% 72-013 (Rev. 3/78) �LJI PA I C, I F:" 0� L.- I _F V C3 F- ����C11,44 C) FQ! Ph IE3 E_, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGEo HK 99�01 264-4720 PERMIT NQ: 840545 DATE ISSUED: 05/07/84 APPLICANT: WINTERWISE INC" ADDRESS: 7400 E. 201-1-1 ANCHORAGE, AK 995O4 CONTACT PHONE: 333-5L,377 LEGAL DESCRIP: SUBDIVISION: LILAC PARK LQT: 3 SECTION: 22 TOWNSHIP: 121\1 RAN8E: 3W LOT SIZE: 64042 (SQ.FT^ OR ACRES) MAX BEDROOMS. 3 BLOCK: 2 Listed below are the options available to you in designing your, septic system" Choose the option that best fits your site. ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS [ certify -Uhat: 1" I am familiar with the P8qu1rements for onsit.e seweps andwells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2" I will. install ,-Lhe system in accordance with all.MOA cxi6egancl rogdlatinns, and in compliance witk.the design criteria of this permit. 3" I will adhere to all MOH and St�te o� Alaska requirements �or the set back distances From anyexisting well, wastewater, dirflposal system or public sewer/age system on or any adjacent or, nearby lot" 4" I understand that this permit is valid for, a maximum Of 3 bedrooms and Any eDlaPgement will require an aidditional permit" IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRIC.AL PERMIT AND INSPECTION MUST BE OBTAINED; (2) �S_BL/ILT8 WILL NOT BE HPT'RUVED WITHOUT AN ELECTRICAL INGPECTION REPORT; AND (3) THE ELECTRICAL WORK MUGT DE DONE BY A LICENEHYED ELECTRICIAN, . 8IGNED DATE: ~����~�_~~_~_~_~~��-_~-_~~~�.__ APPLICANT: WINTER���� SE INC. ISSUED BY AA�� ' 61t�) #a/��5S'7o5AP MEt-l- WL -L *�CC43 *VAI- 14A//D Actq \ �� / ��F�. IEEE: Im 117-: 0 -A F�l FIE] 0 "1 P%H DEPTH TO PIPE BOTTOM (FT.) 4,0 4.0 4.0 GRAVEL DEPTH (FT.) 6"0 0"5 3.5 TOTAL DEPTH (FT.) 10.0 4"5 7"5 GRAVEL WIDTH (FT") 2.5 21.0 5.0 GRAVEL LENGTH (FT.) 46"0 40.0 60.0 GRAVEL VOLUME (CU,YDS") 27.6 ` 31"1 44.4 TANK SIZE (QALS) 1,000.0 ** 1�000.0 ** 1,000.O *a SOIL RATING (SQ.FT"/BR) 183 183 183 ^ ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS [ certify -Uhat: 1" I am familiar with the P8qu1rements for onsit.e seweps andwells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2" I will. install ,-Lhe system in accordance with all.MOA cxi6egancl rogdlatinns, and in compliance witk.the design criteria of this permit. 3" I will adhere to all MOH and St�te o� Alaska requirements �or the set back distances From anyexisting well, wastewater, dirflposal system or public sewer/age system on or any adjacent or, nearby lot" 4" I understand that this permit is valid for, a maximum Of 3 bedrooms and Any eDlaPgement will require an aidditional permit" IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRIC.AL PERMIT AND INSPECTION MUST BE OBTAINED; (2) �S_BL/ILT8 WILL NOT BE HPT'RUVED WITHOUT AN ELECTRICAL INGPECTION REPORT; AND (3) THE ELECTRICAL WORK MUGT DE DONE BY A LICENEHYED ELECTRICIAN, . 8IGNED DATE: ~����~�_~~_~_~_~~��-_~-_~~~�.__ APPLICANT: WINTER���� SE INC. ISSUED BY AA�� ' 61t�) #a/��5S'7o5AP MEt-l- WL -L *�CC43 *VAI- 14A//D Actq \ �� / ® SOILS LOG MUNICIPALITY OF ANCHORAGE � PERCOLATION .., DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 325 L. Street, Anchorage, Alaska 9901 354-4721N SOILS LOG e PERCOLATION TEST Joe Cange Test Pit II DATE PERFORMED:_ 08-11--83 PERFORMED FOR: .m,_,.�d�..—��.._�.�®.�,.A (located within SW1/4, Sec.22, T 12 N., LEGAL DESCRiPTiehr Lilac Park Subdivision R 3 W., S.M.) 5 DEPTH TOpsO4 -�4 SLOPE mSITE PLAN 0.1 F'4, brown sandy silt y interlayered with F2/F3, silty sand, damp, stiff 3 4 5V� 6— 7 ML IO"" /J��� _ ,' r�v .w - r - 10 11 WAS GROUND WATER S ENCOUNTERED? NO _ LD P .12 E IF YES, AT WHAT DEPTH? 13 14 Date F2/F3, brown Net Depth to SP silty gravelly 15 — sand, damp, dens Water SM 16 - BOP 16' 17 - 44FS�V ns��a R� . e� W.OF Ar i °OOOi. p, 9 fp 1- er Yu 18- APO 1 00 904 °o"...'•.. 19 3� V1 •. ta.oe o..�u(..... ...... '9 • e 20- A Melvin R. Nichols ` a1',0 ® °+ No. 4113-E COMMENTS_, %III, � Reading Date Gross Net Depth to Net Time Time Water Drop 0 1- 2:55pm 0 1 3:25pm 30 8-1/4� 3� 2 3:55 30 --3 4 3 4:25gm 30 -9 16 A1/ 4 - 4-55xm 30 -1 2 Reading Date Gross Net Depth to Net Time Time Water Drop 0 08-11-83 2:55pm 0 1 3:25pm 30 8-1/4� 3� 2 3:55 30 --3 4 3 4:25gm 30 -9 16 A1/ 4 - 4-55xm 30 -1 2 2-1/ PERCOLATION RATE 13 �-(nrinutesftnchl TEST RUN BETWEEN 4 . 5 IF ANO . F T PERFORMEDBY:_C. Feldman CERTIFIED BY: DATE: --00022 p 2 LL (3 N ul W n Cl F- > I - 'i z 00 > ato0) Fr a ul —' r Nr - r - N � W In \ I N ® t�13NIV 9 l.l'L901 0 rw fn V9,99 -.1. GS'GZ1=l < Ln Nr Rg N \ N ® CD - E w ? \ CU to o op OnNO U) J� O fQ _ •-r.. _•N ___ to WU _ ov u. O O p m N rn 0°z 16— 2s1-�-C)Zpw m V O Vw.w41Uwa4 )C) r lu t9 F O u t O r o ga in N w Q 'T w f U - N qJ w u •- ) rc l - 1 UlIco at Q C) d totoO ( , 0 rw fn V9,99 -.1. GS'GZ1=l < Ln Nr Rg N \ N ® CD - E w ? \ CU to o op OnNO U) J� O fQ _ •-r.. _•N ___ to WU _ ov u. O O p m N rn 0°z 16— fn 1 R \ low to N R toRw w oww 1 } ,', > o > X ((L d uI py \ } a rr c 7 to � L O O b' cD c1 0 (D 9/ 000c / 00'08 T [linos w m_ 511 W (n — —' — — -- -- 9 0 L, .l a v n \A F CU a \ 9 Z' H.L 8 fn V9,99 -.1. GS'GZ1=l 6Z'Jzl a ECJ m CO m CD - mll`UF�;2--�f.-r Ib'09. o ti N -999,9 2E ov u. O O p m N rn 0°z 16— m V O u r lu t9 F O u t O r o ga in N }` Q 'T w f U - N qJ w u •- ) rc l - fn 1 R \ low to N R toRw w oww 1 } ,', > o > X ((L d uI py \ } a rr c 7 to � L O O b' cD c1 0 (D 9/ 000c / 00'08 T [linos w m_ 511 W (n — —' — — -- -- 9 0 L, .l a v n \A F CU a \ 9 Z' H.L 8 £8'OL v 0, ZL L199 UO OOoIZ m 11 1 BoV�14,VY56 l', .00'- 91+ O.ZIJ_ . 00 09s -n s i 00001CL fn <D t N trl a ECJ m CO m CD - tC) £8'OL v 0, ZL L199 UO OOoIZ m 11 1 BoV�14,VY56 l', .00'- 91+ O.ZIJ_ . 00 09s -n s i 00001CL M. a,$ unicipa ty k'�� .� POUCH 6-650 ANCHORAGE, ALASKA 99502-0650 of " �� � _,, � (907) 2.64-4111 Anchorage � TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit #: 840697 January 31, 1985 TO: Permit Applicant. SUBJECT: Lot 3 Block 2 Lilac Park Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264•-4720. Sincerely, WIT Keith E. Ban dt Supe visor p Environmental. Engineering Program KEB/ljw enc: Copy of Permit SWP/057 11", 0L-11 11"'d Z C::" * IC T 1. "T' 'v' ICAI �����in. ��C-3 FEE: DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION � �[ 825 L STREET, ANCHORAGE, AK 99581 \V» 264~4720 ��rT ��V�~~��� ^�K� ����K~K_ 0�U���U��^�� PERMIT NO: 840697 DATE ISSUED: 08/15/84 APPLICANT: JIM STRATTON ADDRESS: 2518 E. TUDOR' SUITE 204 ^ ANCHORAGE9 AK 99508 CONTACT PHONE: 563 ... 3361 LEGAL DESCRIP: gUBDIVISION:` LILAC LOT: 3 DLOCK: 2 SECTION: 22 TOWNSHIP: 121\1 RANGE: 3W LOT SIZE: 64042 (SQ"FT" OR ACRES) I certify that: 1. I am {amiliap with the requiremEnnts for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" it. I will insiall the sys-Lem in accordance, with all MOA Mdes and regulations,, and in compliance with the design criteria of this permit" 3. I will adhere to all MOA and Statu, of Alaska requirements for the set b�ck distances from any, existing well, wastewater disposal s)/stemor 131.1blic sewerage syst on this or any adjacent. cu, OeuiPby lot. SIGNED APPLICANT: ISSUED BY DATE: JIM STRATTON DATE: 0 �� -.... ..... .- � v��----- � cc v Ko M -W DRILLING INC. P.O. BOX 110378 ANCHORAGE. ALASKA 99511 PHONE 349.8535 R LEGAL DESCRIPTION �.-�� LEGAL OWNERS BANK OR LENDING INSTITUTIONS CURRENTLY HOLDING DEED OF TRUST INVOICE NO 2349 DATE_ 7- %c - ,7e — UNIT CITY. I MATERIALS I PRI E I AMOUNT HOME PHONE WORK PHONE p /�J J�� TOTAL MATERIALS .!-WELL NUMBER DIAM TffR DEPTH STATIC LEVEL GPMDRAWDOWN // o /' , UMP MAKE HP SETTING VOLTS PHASE AMP RATE SERIAL NUMBER MODEL SCREEN LENGTH SLOT SIZE LINER/SCREEN OF WORK _DESCRIPTION DATES 3<2 WORKMAN DATEIN OUT HOURS RATE 0 All charges shall be paid in full within ten r' , 1000 Sj1d LABOR days unless other arrangements are made prior to drilling. The customer shall pay in- MATERIALS (FROM ABOVE) terest at the rate of 1 % % per month on any OTHER CHARGES amount not paid within ten days. Failure to pay may result in a lien against the property. ---- — CUSTOMER SIGNATURE PAY THIS AMOUNT —0 +�+en_�..--r».- __"`�-�A'a�R4-:[�.euvae.�. zs.-.--.�'�3' n�-���•^:i�'�F++�- bT: -:-^�'sa:3..-r.; en CONTRACTOR MR ap�stet us nea DEPAfrT%"MT of NATAWAL NEBOtR M DWISON OF WATER wnt 01 WNW O. w�l cam; OCT -7199 ALASKA DNR/D1V OF A AV W" f7 ovm BATF OF. COMPLETM wqm of halm Ile# DO" TO UAM WAM UNEL � ofalfaut: � .tr rover D �61e fl9ow 0 pubs¢ *up* D CASH Dian: IM to t w tra« ' w&2—ft VAU VITAU OMM4 Wft errs El end © pe knmd O open hole Dooft of +. to n sca t t Mw n.. In. GRAM PAM TYM ar= TM vokaae: Vl fjom ft to AMPTUM, rtNNPfr#3 CFVEL Afm YID: b #eftar twn: PUMP NOTAKF OtPt'ff; it fkwaboower1:j )i R� Rewawcs _I PLEASE IL WHITE COPY WATER OF LOQ TO: ata � T'* EAGLE RF K 99877-211$ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930122 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:STRATTON JIM & CHRIS OWNER ADDRESS:12.222 LILAC CTR ANCHORAGE, ALASKA 99516 PARCEL ID:015211.27 LEGAL DESCRIPTION: LILAC PARK BLK 2 LT LOT SIZE: 64042 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 2 DATE ISSUED: 5/25/93 EXPIRATION DATE: 5/25/94 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RWR: THIS PERMIT IS TO DRILL A NEW POTABLE WATER SUPPLY WELL THE EXISTING WELL IS LOCATED UNDER THE HOUSE AND CANNOT BE ACCESSED FOR SERVICE, AND IS PRODUCING SILTY WATER. THE EXISTING WELL CAN BE USED IN ANY FORM FOR A POTABLE WATER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, £325 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 SOURCE, AND MUST BE FROM:Y THE POTABLE WA NOT BE PER RECEIVED B ISSUED BY: COMPLETELY DISCONNECTED AND ISOLATED T.ER SUPPLY SYSTEM. CROSS -CONNECTS WILL PAGE 2 OF 2 DATE: U � UI DATE : t �Z j5�y 61 d� Cr,-dt 3Y ?-3165 U 7 v/s� lVE e ti N � s 2_. (}1 r.ParcH •, • Qa t < �I Imo' Ye 14 _�o m. • •-. .-.-Jawlspacm +',.OT PLAN: I AS -BUILT: F.Y.P5, ENGINEERS, L.It"AG G I �"J00 la, -/frl, pew A+0 IJ (S YV1%Y� vl I f'�l1G N(y « ellen+ W/n Ferwt�e � GRID: DRAWN BY: P•i=/' C b+. 010-) aeCi,,'- f z lei 4A c�l•<' C7rV C' i (J (1" f U 7 v/s� lVE e ti N � s 2_. (}1 r.ParcH •, • Qa t < �I Imo' Ye 14 _�o m. • •-. .-.-Jawlspacm +',.OT PLAN: I AS -BUILT: F.Y.P5, ENGINEERS, THAT I HAVE SURVEYED THE FOLLOWING DEV011111.0 PFIDPEHIY, I LILAC. PAP -K SUB. ANCHORAGE RECORDING DISTRICT, AK. . ;"!'P0VEMEN7S SITUATED THEREON ARE WITHIN THE PROPERTY LINES •:� ^SACH ON THE PROPERTY LYING ADJACENT THERETO. THAT NO '•��+�6. �'. 'ROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES 1'-+A7 THERE ARC NO ROADWAYS, TRANSMISSION LINES OR OTHER "Hc�•;r5 ON SAID PROPERTY EXCEPT AS INDICATED HEREON. ." _AY OF FE('j. 1985• ANCHORAGE. ALASKA. - 'SPE:: •';NSIBILITY OF THE OWNER OR GUILDER, PRIOR TO CONSTRUCTION. '0 ''i: :-,• ' ];:CSEO BUILDING GRADE RELATIVE TO FINISH GRAOE AND UTILITY _•,S--'.9 10 DETERMINE THE EXISTENCE OF^ANY EASEMENTS. COVENANTS '• fir A4`�► • '': rr.oM•e n. euitn 0 M 71 3167-5 L.It"AG G I �"J00 A+0 4p370 a sourN BO.oO :0•;c0 1Y -G « ellen+ W/n Ferwt�e � GRID: DRAWN BY: P•i=/' C b+. 7125 OLD SE' ,,APO HWr. INC. ANCHORAGE, ALASKA 99502 THAT I HAVE SURVEYED THE FOLLOWING DEV011111.0 PFIDPEHIY, I LILAC. PAP -K SUB. ANCHORAGE RECORDING DISTRICT, AK. . ;"!'P0VEMEN7S SITUATED THEREON ARE WITHIN THE PROPERTY LINES •:� ^SACH ON THE PROPERTY LYING ADJACENT THERETO. THAT NO '•��+�6. �'. 'ROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES 1'-+A7 THERE ARC NO ROADWAYS, TRANSMISSION LINES OR OTHER "Hc�•;r5 ON SAID PROPERTY EXCEPT AS INDICATED HEREON. ." _AY OF FE('j. 1985• ANCHORAGE. ALASKA. - 'SPE:: •';NSIBILITY OF THE OWNER OR GUILDER, PRIOR TO CONSTRUCTION. '0 ''i: :-,• ' ];:CSEO BUILDING GRADE RELATIVE TO FINISH GRAOE AND UTILITY _•,S--'.9 10 DETERMINE THE EXISTENCE OF^ANY EASEMENTS. COVENANTS '• fir A4`�► • '': rr.oM•e n. euitn 0 M 71 3167-5 Municipality of Anchorage On -Site Water & Wastewater Program - (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-211-27 Complete legal description Location (site address) Expiration Date: I / LILAC PARK S/D• BLOCK 2 LOT 3 12222 LILAC CIRCLE, ANCHORAGE, AK 99516 Current Property owner(s) JIM STRATTON Day phone Mailing address 12222 LILAC CIRCLE, ANCHORAGE, AK, 99516 349-3569 Real Estate Agent STAR MARSEfT W/ DWELL REALTY Day phone 240-1310 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request For. Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 0 0150 Date of Payment /181/114 /, 1�14-7 Receipt Number -4-.1 A�7''//Ca�� COSA# 050,141003 Distance: — l_ Date: i ! i Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. 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 ofthe 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 the 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. 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following 337-6179 Date I CT 006004 o10< 0 ........... , 9S 4p0p (may(;/ ANc�rr,/i 0 z pN gVE tions: WAjER AIND �o WASTEWATER o_ Original Certificate Date: The Ntc/rlicipality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTCHMENTS: COSA Checklist Z Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 'Rw 11 pW If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: LILAC PARK S/D; BLOCK 2, LOT 3 Parcel ID: 0 15-211-27 A. WELL DATA AI AGRICULTURAL WELL/POTABLE WELL PRIVATE/ Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES/YES tssa/ Date completed 6/15/1993 Sanitary seal (Y/N) Y Y Wires properly protected (Y/N) YES/YES 150/ Iso/ Total depth 167 ft. Cased to 167 ft. Casing height (above ground) 12+/12+ in. FROM WELL LOG AT INSPECTION 7/9/1994 Date of test 6/15/1993 *6/21/2013 Static water level 117/123 ft, *116 ft. Well production 11/10 g,p,m, *3.33+ g,p.m, *FLOW TEST PERFORMED ON WATER SAMPLE RESULTS: POTABLE WELL ONLY o/ 0.120/ Coliform o colonies/100 ml. Nitrate 0.280 mg./L. Collected by: GEG, Ltd. ND/ Arsenic: ND ug./L. Date of sample: 12/30/201 B. SEPTICIHOLDING TANK DATA *APPROXIMATELY 15' FROM HOUSE. Tank Type/Material SEPTIC/STEEL Date installed 8/29-30/2013 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper C. ABSORPTION FIELD DATA Date installed 8/29-30/13 Soil rating .p.d./ft r ft'/bdrm) 0_8 System type DEEP TRENCH Length 40 ft. Width 2.5 ft. Gravel below pipe 7.52 ft. Total depth *13.5-15.1 ft. Eff. absorption area 601.6 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For E bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: min. Final fluid depth = in. Absorption rate >= - g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date - NOTE: 1984 TRENCH CONNECTED AS RESERVE SITE. D. LIFT STATION Date installed Size in gallonsManhole/Access "Pump on" level at in. "Pump off' level E7 SEPARATION DISTANCES level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+/100'+ Absorption field on lot 100'+/1100'+ Public sewer main N/A Sewer /septic service line 25'+/25'+ AGRICULTURAL WELL/POTABLE WELL On adjacent lots 100'+/100'+ On adjacent lots 100'+/100'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+/50'+ Manure/animal excrete storage areas 100'+/100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main 5'+ Wells on adjacent lots 100'+ Property line 5'+ Absorption field 5'+ Water service line 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS �o�e: l�✓l�u��w well 4u5 o,) ess i1 -e ci b- a� G. ENGINEER'S CERTIFICATIONo� OF o `,... t certify that I have determined through field inspections and XeA. review of Municipal recordsthat the above systems are in .""'•""...conformance with MOA COSA guidelines in effect an this date. O..G..ness; ... Engineer's Printed Name JEFFREY A. GARNESS �53 Date ofesslo"oo (Rev. 11/05) m m w N nm� D m(nz r z0� m Ogo s U)ol II =Z A z=O O m zz 1u 0 M, 000 ?0m m C)_ z r 0 N �� 1 .04' NAw i x as c�0 ' <� #, ••O 00 % < S / 00 tr Xxx F � g0�<gmmm o - o ymrym Ndga�3� �-�� N 20 N >: 0 0 4 0 0 � t0 N Q ®� mm E55�mm -pfm 3m oar o Um Z =oss�H- a 0 m a c a m y m C0.- df u�ma 3& OM mm mm a1�"o3ofD3 <aa A .c a=r -0 00 o'A gym m o 3 3 wd Z�?� O °G a N n0 0 S 0 3. r m v O a ? O n i a 2 J d a N 0. z 05 D nl f/mmp 0a m m �' y N 0 J � O w � 0 rJ W A m m El R=330.00 L=116.52 N'SoS936 F 1Sn „_ ` ` ---------------- ae� ��aP n967� ; _.vu w >>`\� 40,,0 . -Ve9et�vatict eRSat�et�Fa e p Meet i i Zro m D n LILAC CIRCLE m y Og 3 0 m o •t r O r tir � � w �o •o apo o�ti DCO Z9l �o N S co p CO0 o 0 O N O N � N CP (n m 0 i i Zro m D n LILAC CIRCLE MUNICIPALITY OF ANCHORAGE .' DIVISION OF SNVT.RONMFNTAT. HEALTH DEPART:4EN1. OF HEALTH AND ENVIRONMENTAL 12ROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIF'ICAT'E: General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location/ (,address or directions) (b) Applicants Name �� TelcRhone Home Business Applicants Address -//-' (c) (c) Applicant is (check one) bending Institution ; Otmer/builder ; Buyer ; Other (explain); (d) Lending Institution1�..:ta_ �� ,..-"' �,� J'- Thone Address /5-0 c` (e) Real Estate Co. & Agent Address Telephone (€) hail the HAA to the following address: 2. Type of Residence Single—Family 520 Multi—Family Other (describe) Number of Bedrooms .3 3. F7ater SupR pL 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 OnsitePublic � 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. V (rage I of 2] i 3 132- lei/rte f�� 5e Engineering Firm Providing Inspections Tests File Search, Data and 7nEornation 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 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 lAtnicipal.ity 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 regula- tions in effect on the date of this inspection. Name of Fi; zn /� ��1�fc�ia���i a Q C �°f.�.��-2�J'vC'_n� Tel ephone _1.2cr� :.� zQ Addres Date N b® DHEP Approval f0 f;c=c: 10 r -C e S' ENGINEER SEAL) l 1 Approved for l�(h-aA bedrooms Approved Disapproved 051 Conditio cGccSoaaaoo 0000ec oo,. o•/ C. Rr. id, .la 0 No. 22514.'d 'Perms of Conditional Approval—_--- CAUTION pproval ___@ �.--- CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STAT13 OP A7ASI(A. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND mm LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL, AND STATE REQUIRE- MENTS. 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 014ISSIONS IN THE PROFESSIONAL ENGINEER'S WORK (DHEP SEAL..) RR4/ej/DLa [Page 2 of 2 ] 7-19-84 IMUNIC P. DEN. q; MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 - A. WELL DATA Legal Description: 4,5-f3 8/K.2 Lr � --- _SIV 230 Ss1.2 _ Well Classification If A, B, cr C, D.E.C. Approved(Y/N) Well Log Present (Y/N) Date Completed U JZ4N� Yield, Total Depth -+- Cased to 1 S 6 Depth of Grouting (�GiCroa.Uv, Static Water Level ` //7 Pump Set At Casing Height Above Ground /,' Sanitary Seal on Casing Y ) Electrical Wiring in Conduit (y&0 Depression Around Wellhead Separation Distances from Well: To Septic/Holding Tank on Lot 1OV" 0 On Adjoining Lots >& To Nearest Edge of Absorption Field on Lot ZRQ .10; On Adjoining Lots To Nearest Public Sewer Line/,¢ To Nearest Public Sewer Cleanout/Manhole ANA- To Nearest Sewer Service Line on Lot Water Sample Collected By /_hM Date Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed 7�aolkq Size /,21) No. of Ccmpartments Z _ Standpipes ) Air -tight Caps 69 11) Foundation Cleanout lam) Depression over Tank (Y Date Last Pumped I(%� Pumping/Maintenance Contract on File (Y ) 't) ; for % Holding Tank High -Water Alarm (Y/N) +)/A—Temporary Holding Tank Permit (Y/N) `V14 Separation Distances f=an Septic/Holding Tank: To Water -Supply Mll /0,9" To Building Foundation �7 To Property Line 7(d 1 To Disposal Field To Water Main/Service Line �LIIA To Stream, Pond, Lake, or Major Drainage Course k)/.k Comments j 71ke 'az_&' 0r1w��� Receipt # Date Paid:-� -�- Amount: (Page 1 of 21 2-15-84 �,3 6z tiiJ4C PaAk— C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 18,30 Type of System Design 7RE Date Installed 7/z%c,/ Length of Field -3' Width of Field _21,S ' Depth of Field /p Gravel Bed Thickness Square Feet of Absorption Area 63 6 'A Standpipes Present�(O�N) Depression over Field (Y/il� Date of Last Adequacy Test Results of Last Adequacy Test AJ!A Separation Distances from Absorption Field: To Water -Supply Well 1.2.0 To Property Line ,24" To Building Foundation To Existing or Abandoned System on Lot A)(A- ; On Adjoining Lots �'&D"Q z� To Water Main/Service Line ti/A- To Cutbank(ifPresent) 4)L4 To Stream/Pond/Lake/or Major Drainage Course IV IA - To Driveway, Parking Area, or Vehicle Storage Area 2S Com,ents (' �� k D. LIFT STATION Date Installed °U�,Q— Dimensions `N//, Size in Gallons �`�//� Manhole/Access (YIN) "Pump On" Level at IU/� "Pump Off" Level at High Water Alarm Level at YOM- Vent (Y/N) Tested for N(f- Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(Y/N)� Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. 1 ;9;nff _ ®h [ Signed ic- ��.,�'� z�s ��ate /� S Company f`CS MOA No. Fg_ Oz y I KB1/d5/s pec e;cv 2E G - 56(r R7�gcldE� cc�7 r��rc 1 G I��F� 85 [Page 2 of 21 2-15-84 we „va�l�� 74 j J vG c� v C r c� f J- 1 f ./ ,/(i c, > c� G <X 1'1 c� w O vi �G ✓ C' 17' iYlrCu? v� Gti%/ Tl�C� ACry wewl� u�C /oU��r �v �l.C� 1cc✓L C711G/ .�A P v�/ vti P. yGC ci vt/ac (r� / G YG lv J� �"71 �G P ve,o//J GI s7 1 6� IRESCOM ELECTRIC, INC. BOX 319R SIRA 319R ANCHORAGE, ALASKA 99507 19 FEB. 1985 This is to certify that the well head has been wired in accordance with the State and National Codes. There is a weather proof box mounted on top of the well casing and that all wires are run in the proper conduit to the contrdnl box. This statement if for Lot 3 Block 2 Lilac Park Sub. for "linter Wise Const. GLENN L. GIBSON FRES. /Vr 0 Z, P aM7- L3 GREA,ER ANCHORAGE AREA BOR,. JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-51TE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE J FROM W ELL ~L~"~ INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATERIAL'~-t~ ~-~-~ COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY ('~-~"~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL JO~-~ //..FOUNDATION ~ ~ I NEAR ST LOT LINE ~ O OF LINES ~ TRENCH WIDTH~ IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE L~ ~ I ]~ J DEPTH OF FILTER · MATERIAL BENEATH TILE_~ .~ IN. ABOVE TILE IN. NUMBER OF LINES / DISTANCE BETWEEN LINES ABSORPTION AREA GoO DEPTH: TOP OF TILE TO FINISH GRADE WELL: ~ C ONSTROCT,ON ,t BUILDING NEAREST NEAREST FOUNDATION ~O , LOT LINE,~'O~, SEWER LINE CESSPOOL. / OTHER SOURCES ~ DEPTH '~" DISTANCE FROM: SEPT,C ' / O~~ ~/~ /~SANK /'0~-SYSTEM SEEPAGE APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM Form EQ-032 F'E:i-;?H I T E:O;:':: ::LDE:Eg '_:.:.;'I"Rf4', t:~'.]'. L..CFt' SIZE 'F'-~-'F'I~: OF' :iii;Oil.. RB:5OI';~:Ii~Ft':tiCd'.,I S'.r'STEf'i :[[~;: 'I:"F:ENC:H I"l:l::ll;-;i_l:l"i(Ji"l I',ItJ!'iBIEI:;: C)t:: BEEIi)F;'.E~C)HS 4 SOiL Rl::ll" I I'-,IG 'HiE t:;::E(:.!LI 1[ F;:l:i~:D S :!: ZEi: OF:' THE; SO :l: I... i:,:l~-]il:E;IZIR(::'-I- .1_' O1'.,I S',?S'TEH I S: TH!E LEt'4EiTH [:,]:HIEt'.,ISIEd'.,I IS 'T'HE: LENGTH (Ihl I::'EEZT::, OF THE TI:;~'.IEI'.,!C:H O1<: D,I:;~:FIINI::tE[LD. 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OFf: ;;i:E~E~ FLEET (::C)F~: F:I F:'LJI~:','LIC 14ELI ::ii;F'ti'~:E:iF:':[CI:RTICff',IS (::It",tD C:Ed'.,IE;TF'.LIC:-I'ZEd",I [)tFII2it~tFIHS FtI:;~:E: ff,,,'FI]:[_FIE~LE TO ]:NSIJF~'.tE I::'F~'.OF'EI;'~'. :I: I".!~;~;"i t::iLI.. F:t-i' :( I.-.'1 I C:EiF';:'i"iF'T' 'f'HFIT' :1.: i FIt"t I:'I::tf"iiI..tt::IF:: 1.4ITH THE: REQI_I:IiREiHENT'.E; F'OR Ot'-,I-S, ITtE ::.;E.b. IEt:;L'.:_:; al'.,tli:, 14E[..L.L:i; I:I:~:; 'E;ETt' I::'iL~;iF;'.TH (?,~'r' THIE t"!t...!t",!;[C:iF't::IL. IT"r' r:)F FII'.,ICHOF'.FtGE. 2: :!: I4:[t.t.. I i'.,I:E;'IFIM.._ THE '_:iT.~.'t;.:;Tl:EM ]:h,! F:iE:C::OF'.E:,FI!'.,tCIE I.,.I:t:TH THE C:O[::,E:'_:.i;. t,I , I::, SEi.,.fEF'.:::,T--tell f"ll::l"r~ l:~'l:::::dl];F;'.E ~:I",ILFII;?C'iEHli ",F'F Il:::' THIE ':i:. Z I_.!t",i[)Eit:;~:'.~i;'t'I:::IF,I[:' 'I'I"IFt"i' ~i1"11:~: .... '-~ ": ........ · I:'~'.IE:r:;ID!!;hlCE ]::[; F;'.E:HEIE:'i!!LEil) 'yI) :(t'4i:i:LI._IE:'E i"IE~F'.E TI~4FIN ":t E~EE:'F;'.EIOhiS. ';;;;F;FE!i';!!;;:;ii:i:F' ' 4;i!::i::i¢i;iiE E;::i, , . , SOILS LOG Per£ormed £or__ : ~~~/k_ Legal Descrip~ion~~,l~ ~ ~ ~ tO Soil Description ....... ¢-~,.-:)--;-;v~ ----8-- -dS- -20- Total Depth Was groundwater enco~mtered ~ Depth to bedrock ~ ~ O' . ? What depth How determined~ Respectfully submitted, Gary F. Player Consulting Geologist