HomeMy WebLinkAboutLILAC PARK BLK 2 LT 10
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231280 PID Number: 015-211-34
Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New A Upgrade
Name
KEN AND PAT THOMPSON ABSORPTION FIELD
Site Address ❑ Deep Trench ❑ Wide Trench ❑ Bedound
12031 LILAC DRIVE *ANCHORAGE, AK____]_El Other
Phone Number of Bedrooms Soil Rating Total depth original grade
907-223-7261 6 GPD/SF Ft.
LEGAL DESCRIPTION Depth to pipe invert from origin:��Ft.
Gravel depth beneath pipe
Subdivision Block Lot
LILAC PARK; BLOCK 2, LOT 10 Ft.
Fill added above original gr Gravel length
Township Range Section Ft. Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES Ft. Ft.
To Septic Absorption Holding Sewer Total orption area Number of trenches Dist. between trenches
From
Tank Field Lift Station Tank Line Ft2
Ft.
Well 100'+ 25r+ TANK [9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other
or z Manufacturer Capacity
Surface Water 100'+ GREER TANK 1500/1000 Gal.
Material Number of compartments
Lot Line 5'+ NA HDPE 1 /1
Foundation 101+ LIFT STATION
Manufacturer Capacity
Remarks PER CONTRACTOR OLD TANK FILLED WITH CONCRETE Gal.
Alarm location Electrical installed by
PIPE MATERIAL House to tank D3034 Tank to
Installer grainfield D3034
DENALI EXCAVATING Drainfield X3034/EXISTING CO/MTD3034
Inspector GEG BENCH MARK (Assumed elevation) 100.00 ft
Inspection
dates: 19I 9/20/2023 2"d - Location and description
3'd - 4'" -
BACK DOOR THRESHOLW:i_ce�6
ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 011 7-
p6�®�
OF A
A .ter
Conditional Approval: Date oo �� • • • �IS,��
oa Q' T 0
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D
Septic System �/v QO �, '. of r A`G.oness.-
Approved Date q 23 04�nf(Z� r323..��c�oo
`Dem rolf essilon�000
Note: this approval d j of include well permit requirements. #Aeccsea ���0000�a
(RPv n5/02/1A1
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PERMIT NUMBER: RECORD DRAWING PARCEL NUMBER:
OSP231280 015-211 1-34
l 1 •/
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A B
MH t18.6 88.2
ST1
23.4
89.3
DBL1
24.9
89.8
DBL2
ST2
ST3
DBL3
DBL4
26.2 90.2 I
33.5 96.2 � I
35.1 97.3 I\
36.1 982 \ I
PIPE LOCATOIN SHOWN PER I \ \ I
AS -BUILT SURVEY .DWG FILE N.
PROVIDED BY SURVEYOR; SWING I \
TIES WERE DERIVED IN AUTOCAD I
i I
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J HOUSE
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NEW 1500 GALLON SINGLE I
COMPARTMENT GREER TANK4\ FC
U / NEW 1000 GALLON SINGLE
QU / COMPARTMENT GREER TANK,
I I I
,� 11 c
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182
'SUMED LOCATION OF EXISTING FIELD
PER CLEANOUT AND MT LOCATIONS
DRIVEWAY
qEt
ENGINEERING - SALES - CONSULTING
3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507' PHONE 19071337.8179' FAX (9071338-3246 * WEBSITE: vrxw.aarne—mmneenna.aom
PREPARED FOR:
KEN AND PAT THOMPSON
LEGAL DESCRIPTION:
LILAC PARK; BLOCK 2, LOT 10
TYPE OF WORK:
SEPTIC TANK RECORD DRAWINGS
PHONE NUMBER:
907-223-7261
PAGE NUMBER:
2OF3
DRAWN BY:
D.J.G.
DATE:
9/25/2023
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PERMIT NUMBER: PARCEL ID NUMBER:
OSP231280 RECORD DRAWING 015-211-34
TOP OF TANK AT INTLET = 92.81
INVERT OF BUNG AT INLET = 92.11
TOP OF TANK AT INTLET = 92.31
INVERT OF BUNG AT INLET =
FINAL GRADE = 97.4-97.6
TOP OF TANK AT OUTLET = 92.81
1500 GALLON SINGLE COMPARTMENT GREER TANK
FINAL GRADE = 96.6-97.4
ST2
1000 GALLON SINGLE COMPARTMENT GREER TANK
INVERT OF BUNG AT OUTLET = 91.90
TOP OF TANK AT OUTLET = 92.31
INVERT OF BUNG AT OUTLET = 91.46
LT ,
. ENGINEERING - SALES �, CONSULTING mamma" ,�
3701 E. TUDOR ROAD. SUITE 101 ANCHORAGE, AK 99507' PHONE (907) 3375179' FAX (907)338-3246 - WEBSITE: —garn—ng neenng.c m
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
KEN AND PAT THOMPSON 907-223-7261 3 OF 3
LEGAL DESCRIPTION: DRAWN BY:
LILAC PARK; BLOCK 2, LOT 10 D,J.G.
TYPE OF WORK: DATE:
I.- SEPTIC TANK PROFILE 9/25/2023
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231280 Effective Date:
Work Type: SepticTank Upgrade Expiration Date:
Tax Code Number: 01521134000
Site Legal Address: LILAC PARK BLK 2 LT 10 G:2736
Site Mailing Address: 12031 LILAC DR, Anchorage
Owner: THOMPSON ALASKA COMMUNITY Lot Size in Sq Ft
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms:
This permit is for the construction of:
\o�',cn s(
tparttneut
9/8/2023
9/7/2024
69418
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
may: �_S5 (te � +0 Date:
Issued By: Date:
R
MUMUPALI TY OF ANCHORAGE
Development Services Department Phone. 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-211-34
Property owner(s) KEN AND PAT THOMPSON
Mailing address 12031 LILAC DRIVE *ANCHORAGE, AK
Site address 12031 LILAC DRIVE *ANCHORAGE, AK
Day phone 907-223-7261
Legal description (Sub'd., Block & Lot) LILAC PARK; BLOCK 2, LOT 10
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 6
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial
Single Family (SF) ❑
Septic Tank
Q
Upgrade
(w/wo AD U)
Holding Tank
❑
Renewal ❑
Duplex (D) ❑
Privy
❑
Multiple Dwellings ❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 225 Waiver Fees:
Date of Payment: Bf�1Z3 Date of Payment:
Receipt Number: 003 11 G Receipt Number:
Permit No. 05P2312 2rC Waiver No.
GADevelopment Services\Building Safetyl0n Site Water and Wastewatefforms\Client FormsWermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231280, Deb Wockenfuss, 09/08/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231280, Deb Wockenfuss, 09/08/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231280, Deb Wockenfuss, 09/08/23
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Municipality of Anchorage Page [ of ~'~
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~---~LAJ ¢~"~OO1~' PIDNumber:_
Name:
~y ~ ~~l~ Wastewater System: ~New D Upgrade
Address:
1o~1 5P~~_ ABSORPTION FIELD
Phone: ~~ No ~Bedrooms: ~DeepTrench ~ Shallow Trench ~Bed ~ Mound ~Other
Total ~epth from original grade:
LEGAL DESCRIPTION Soil Rating: I'~ GPD/Sq. Ft.
Lot: ¢~ Block: ~ ~Subdivisi°n:~ Depth to pipe boltom from ~°riginal grade: Ft. Gravel depth beneath pipe~ Ft.
Township: Range: Section: Fill added above original grade: Gravel length:
Number of lines: Distance between lines:
WELL: ~(~New/~ ~ Upgrade Oravelwidth: ~ Ft.I ~ - - Ft.
Classification (Priva/e, A.B.C): Tolal Deplh: Cased To: Total absorption area: Pipe materiel:
Driller: Date Drilled: Static Water Level:Ft. Inst~e~ ~ Date
Yield: ~umPGPM ~' Set at: FI Casing Height Above Ground:Ft. TAN K
SEPARATION DISTANCES ~Septic U Floldin9 ~ S.T.E.P.
To Seplic Absorption Lift Holding Public/Private MaRyfactyrer: Capacity in gallons:
Fro~ Tank Field S,ation Tank S ..... Li .... ~¢~ ~
~ Number of Compartments:
Well [~I ¢1~1 ~ ~ Material:~
Surface
Wat~ NO~ -~ -- LIFT STATION
Lot ~1 ¢~1 ~ Size~ ~nufacturer:
Line ~
Foundation I ~1 ~. ~ "Pump crY' level at~ "Pump Off" level at: High water alarm at:
Curtain ~O~2 ~- Pump Make&Model ~callnspectionsperformedby:
Drain
Remarks: ~~ ~¢ ~ ~ BENCH MARK
Location and Description:
,ns, c,io.s rfo, ed ates: '*
2nd ~~
Department of Health ~ H~n~e~es approval
Reviewed and approved by ~_ .... Date: , ,
72-013 (Rev 9191) MOA 25
PermitNo.'~t~J'~'OOl~' Page_ /~ of ,~
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description:
£.lb~ ?Pre. F- ~JPlUOT'IO/ I~t,OOf¢_ Z PIDNo.: °I~C~ll$¢
\
72-013 A (Rev 9/91) MOA 25
ENGINEER'S SEAL
7760
..... ~,~ _ ,'~
Permit No. S W c~ "~OOl~ Page '~ of '~
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description:
PID No.: 0 1 ~ ?-..I I~ ~-
72-013 A (Rev. 9/91 ) MOA 25
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW920015
DESIGN ENGINEER:MOUNTAIN ENGINEERING
OWNER NAME:CARTWRIGHT GARY T & MARY
OWNER ADDRESS:10231 SPINNAKER DRIVE
ANCHORAGE, ALASKA 99513
PARCEL ID:01521134
DATE ISSUED: 2/13/92
EXPIRATION DATE: 2/13/93
LEGAL DESCRIPTION: LILAC PARK BLK 2 LT 10
LOT SIZE: 69418 (SQ. FT.)
NUMBER OF BEDROOMS: 6 THIS PERMIT: 6
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
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 (iSAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
1. BASED ON ADDITIONAL INFORMATION FROM ENGINEER, PERMIT
AMENDED TO ALLOW INSTALLATION OF DEEP TRENCH. ENGINEER
MUST VERIFY DEPTH OF WATER TABLE DURING INSTALLATION OF
DEEP TRENCH.
2. EXCAVATE TESTHOLE #2 TO DETERMINE IF TRUE GROUND WATER
TABLE EXISTS.
ISSUED BY
: DATE:
/
Mark Pearson
Mountain Engineering
3868 Shannon Circle
Anchorage, AK 99508
May 15, 1992
Susan Oswalt
On-Site Services Program
Department of Health & Human Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519-6650
ECEIVED
MAY 1,5
Oept. HeaJth & Human Services
Regarding: Lilac Park Subdivision, Lot 10, Block 2
Dear Susan:
As per our discussions, I have monitored the groundwater levels at the above
referenced property. The monitoring was in response to your concerns regarding
groundwater levels on adjacent properties.
Test hole #1 has remained dry since the time it was installed in September, 1991.
Test hole #2 was partially filled with soil (probably by kids), and water level has been
consistently 8.0 FT below the original ground surface. In thE; last two weeks,
construction equipment has removed approximately 1 FT of overburden around the
pipe, and therefore the water level is now 7.0 FT below existing grade. The pipe has
also been damaged.
Because Test Hole #1 has remained dry, I am requesting that we be allowed to
change the system design back to the original configuration (see attached drawing
dated May 15, 1992). Prior to installation, we will excavate Test Hole #2 to see if
the pipe has been plugged, or if the water level is indeed 7 FT below existing grade.
If the groundwater level is really 7 FT, we will likely modify the system design to be
more shallow and therefore conservative.
Please contact Brent or me at 562-2514 if you have any questions.
N
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW920015
DESIGN ENGINEER:MOUNTAIN ENGINEERING _~¥-~'T7-~3
OWNER NAME:CARTWRIGHT GARY T ~J~-~/-~
OWNER ADDRESS:10231 SPINNAKER DRIVE
ANCHORAGE, ALASKA 99513
DATE ISSUED: 2/13/92
EXPIRATION DATE: 2/13/93
PARCEL ID:01521134
LEGAL DESCRIPTION: LILAC PARK BLK 2 LT 10
LOT SIZE: 69418 (SQ. FT.)
NUMBER OF BEDROOMS: 6 THIS PERMIT: 6
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
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 (iSAAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
1. BASED ON WATER MONITORING FROM LOT 11, THE SYSTEM ON
LOT 10 MAY NOT EXCEED -6.0' IN DEPTH. FIVE FOOT WIDE
TRENCHES WITH MAXIMUM GRAVEL DEPTH OF 3.0' WIL REQUIRE?~/~
TOTAL TRENCH LENGTH OF 87.0'.
2. ENGINEER MAY AMEND THIS PERMIT WITH SUBMISSION OF
ADDITIONAL INFORMATION ON WATER MONITORING THROUGH
MAY, 1992.
DATE:
DATE:
0
0
0
Municipality oi Anchorage
LEGAL DESCRIPTION:
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
15
16
17
18
19
\
20
1
2
3
4
5
6
7
8
9
10
11
12
13-
COMMENTS
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTER ED?
SITE PLAN
S
L
IF YES, AT WHAT O
DEPTH? p~
Depth lo Waler Afler IOll{~[~t
~onitoring? O 0,:,: q,ot't
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE ~'"~:: (minutes/inch) PERC HOLE DIAMETER ~)I
TEST RUN BETWEEN ~' FT AND ~'" _ FT
PERFORMED BY: ~¢~,'¥'~"~-~,~2J~ I ~1~-... ~,,¢~ CERTIFY TI4AT THIS TEST WAS PERFORMED iN
ACCORDANCE WITI4 ALL STATE AND MUNiCiPAL GUiDELiNES iN EFFECT ON THiS DATE. DATE:
72-008 (Rev. 4/85)
.... OF
LEGAL DESCHIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2o
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
COMMENTS
Township, Range, Section:
SLOPE
SITE PLAN
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth to Water After
Monitoring?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~'~ (minules/inch) PERC HOLE DIAMETER fell
TEST RUN BETWEEN ~ FT AND ~ FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
;' M-W DRILLING, I.¢.
(g07) 349-8535
ANCHORAGE, ALASKA 99511
f
DRILLING LOG
WeB Owner CANGE, JOL
Location (address of: Township, Range, Section, if known; or distance main road
~ lO, Block_.2 Lilac Park Sub,;livi~iop
.UseofWell lrzisatl°n
Size of casing 6" Depth of Hole 183 feet Cased to 176.5 .feet
Static water level 123 ft. (a~Sb~,~) (below) land surface. Finish of well (check one) open end ( );
Screen ( XXX); Per£orated ( )'
Describe screen or perIoratio~ ........ ,'
Well pumping test at__J~a gallons per (~ (minute) for / hours with
of 'drawdown from static level.
Date ofcompletion~eccmber 22, 1083
WELL LOG
Depth in feet from
ground surface
Give details of formations penetrated, size of material, color and hardness
0 .TO 2
2 TO 4
_ 4__TO ~ ~
28 .TO. 60
60 .TO_ 85
85 TO. 100
100 TO. 124
124 .TO. 1 DO
. 1.~0 .TO 168
174
168 TO
174 ..TO. 177
177 _TO_ 183
183 TO
..... TO
RECEIVE
~UOLO~PahIY of Anchorage
D~PL Fle~/th ~ Hur. an Services
Casiug stickuF
O~'gani¢o
SAltY ~and & g[ayel
Silty liazdpan
Silty llardpan
G~avel & Sand loose
Sand
Sandy Gravel
Cravcly llardlmU
Crt[vel wet
Sm~d & Gravel wet
Watcrbeariug ?.ravel
lla~dpau
iNWWA Certified Contractor
q--~nNTRACTOR
MUNICIPALITY OF ANCHORAGE
a�
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 015-211-34
Legal description LILAC PARK BLK 2 LT 10
Site address 12031 LILAC DR
Expiration Date: 12/26/2023
Current property owner(s) THOMPSON ALASKA COMMUNITYPROPERTY TRUST
XThe On-site system(s) is/are approved for 6 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: Original Certificate Date: 9/26/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval—June 2022
NMPAUTY O
Development Services Department
On -Site Water & Wastewater Section
AmCHO RAGE
Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval Application C
,
1. GENERAL INFORMATION
Parcel I.D. 015-211-34
Complete legal description LILAC PARK; BLOCK 2, LOT 10
Location (site address) 12031 Lilac Drive *Anchorage
Current property owner(s) Ken & Pat Thompson
2. ON-SITE SYSTEMS SIZED FOR 6 BEDROOMS
Day phone 223-7261
3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: Q Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel Q Plastic ❑ Concrete ❑ Fiberglass
Age NEW - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed FE� Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: n
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ D O Waiver FPA .ly
Date of Payment y� 2 Z 2,-
COSA COSH
Date of Payment
Waiver #
COSA Applicallon_June 2022
LILAC PARK; BLOCK 2, LOT 10
,Legal Description: -
Parcel ID: 015-211-34
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
9 Well to is filed with Onsite or attached)
Date drilled 12122J83 Total depth 183 ft
to 176.5 ft
Cased
FM Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 12+ in.
?
Date of flow test for CCS SA 7/24/23
Static water level at beginning of test 126.0 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank NEW
Date of pumping NEW
Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 6/27/92
W ALL standpipes present per record drawing
Total measured depth from grade 11.5 ft (max)
Measured depth to pipe invert from grade 'eft (min)
F� N/A — pressurized field.
F-1 Per record drawings, field is insulated.
N Monitor tubes go to bottom of effective.
If not, state depth into effective
E] Presoaked required if
(Required if house vacant or field not us r.rr more
than 30 days prior to date of test
Gallo,ts, introduced •allons date
U-
4 F -- 10 -IMA114 1, Im
Well production at time of test 4.7+ PM
Water storage tank volume N/A . gallons
Well disinfected for coliform test? E] Yes a No
H Coliform bacteria is Negative
Nitrate 1.35 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by GEGI Ltd.
Date 7/24/23
Adequacy test date 7/24/23
Results M Pass
Fluid depth prior to test 21 in
Water added 935 gal
New fluid depth 30 in
Elapsedtime 120 min
Final fluid depth 25 in
Absorption rate 900+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 96 in
Effective depth used 25 in
Effective depth remaining 71 in
,,4fj'es, enter date
Comments/Deficiencies: *TRENCH,(AT EAST END HA8 APPROXIMATELY 5.11 OF COVER.
COSA Checklistguns2022
M
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot,)
Septic Tank/Lift Station on Lot > 100'
Building Foundations > 101
QYes
Community Sewer Manhole/Cleanout > 100'
FE]Yes
if No
ft
Fifl Yes
if No ft
Neighboring Tank> 1001 Yes
if No
ft
Private Sewer/Septic Line > 25' ■ Yes
if No ft
Absorption Field on Lot > 100' Yes
if No
ft
Holding Tank > 1001 Yes
if No ft
Neighboring Absorption Fields > 100'
ErYes if No ft
,ter Service Line > 10'
Animal Containment > 50' LC Yes
if No ft
R Yes
if o
N
ft
Community Sewer Main > 75' Yes
if No
ft
Manure/Animal Excreta Storage > 1001
[■] Yes
if No ft
r_1 N/A —Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot t!0___:(`_1P1ease enter distances if less than required)
Building Foundations > 101
QYes
if No
ft Surface Water > 1009
JDYes if No ft
Tank to Property Line > 5
Yes
if No
ft Wells on Adjacent Lots:
Field to Property Line > 10'
Yes
if Noft
ft Private Wells > 100'
Yes if No
Water Main > 10'
FNI Yes
if No
ft Community Wells > 200'
ErYes if No ft
,ter Service Line > 10'
QYes
if No
ft If tank or field is under driveway comment Belo
F. ENGINEER'S COMMENTS
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Gayness Engineerigg Groul LTD. (GEG)
Engineer's Printed Name - Jeffrey A. Garness
Phone 907-337-6179
=T
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in
accordance with the guidelines and regulations established by the Municipality of Anchorage and industry
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
the systern/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding
the future performance of the well or septic system. GEG makes no representation whether an alternative well
or septic system can be installed on the property in the event either of the current systems fail to perform
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
L (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
COSA ChecklistJune2022
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2S/23
Wockenfuss, Deborah M.
From: Jeff Garness <Jeff@garnessengineering.com>
Sent: Tuesday, September 26, 2023 10:02 AM
To: Wockenfuss, Deborah M.
Cc: Sonja Blewett
Subject: Lilac Park B2, L10 - Soil Cover Over Drainfield
Follow Up Flag: Follow up
Flag Status: Flagged
[EXTERNAL EMAIL]
Regarding soil cover issue (over the drainfield) at Lilac Park, B2, L10:
1. Effective depth of the trench is reported to be 8 feet. The trench is 59 feet long.
2. The invert at the north end of the trench is 5.6 feet below grade
3. The invert at the south end of the trench is about 2.9 feet below grade, indicating about 2.5 feet of soil cover
over the top of the drainpipe.
4. The MT (within about 10 feet of the south end of the trench) extends 11.6 feet below grade, indicating the soil
cover over the drainpipe is about 3 feet.
5. In short, approximately 85% of the trench has adequate soil cover. If freezing were to occur, it would likely be
isolated to the last 10 feet of the trench.
6. It is reasonable to believe that the system has been operating in this condition for many years.
It is my opinion that there is minimal adverse impact associated with the limited soil cover over the isolated portion of
the trench.
Jeffrey A. Garness, P.E., M.S.
President
Garness Engineering Group, Ltd.
3701 E. Tudor Road, Suite 101
Anchorage, Alaska 99507-1259
Phone: (907) 337-6179
Mobile: (907) 244- 9612
Website: www.garnessengineering.com
GARNESS ENGINEERING GROUP, Lt(I
ENGINEERING, SALES,CONSULTINGXERXEs,* d le"Ita
Aer ei CORPORATION treatment AtafA o A.efhorized Dan!,a MtI%'iYi°Pi:�d dint C t systems
tltmot nv t s stems
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
Parcel I.D.#
GENERAL INFORMATION
Complete legal description
~,oT IO ~LK 2 .. LILI~E ]:'t~,~1<
Location (site address or directions)
Property owner GARd
Mailing address 12031
Lending agency
Mailing address
¢ l'qAF~¥ CA~Tt~/~h(SHT Day phone
Day phone
Agent ~o~-~l~E FafHCE~; J2C~< W'~ITE CO, Dayphone
Unless otherwise requested, HAA will be_/Oeld 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.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
NOTE:
72-025 (Rev, 1/91) Front MOA ~21
5. STATEMENT OF INSPECTION BY ENGINEER
o
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/orwastewaterdisposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I furtherverifythatbasedontheinformationobtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm ~'LAT'TOP -FECFI .~v'C3. Phone
Address Iq.~3o ~CHo -<T, f~E-tl, ~< c~c~/(¢
Engineer's signature ~~ ~ ~ Date
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
%?
bedrooms, with the following stipulations:
Additional Comments
The Munioipality 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 MOACY21
Municipality of Anchorage /~
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: LoT /0.,
A. Well Data
Parcel I.D.
Well type P~vA
Log present (Y/N) '7'
Total depth I $.5
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level1
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed I~_/2~/8~ Driller
Cased to ' I-/~. ~' Casing height
Wires properly protected (Y/N)
FROM WELL LOG AT INSPECTION
~O g.p.m. ~ 7. g.p.m. ~
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot /
Absorption field on lot 2 1'7
Public sewer main >/oo'
Sewer service line 1-7o
WATER SAMPLE RESULTS:
Coliform 42 co ( //~'oo ..~ .~ Nitrate
Date of sample: 7/7/~q
; On adjacent lots ~/co
; On adjacent lots ~ / oo
Public sewer manhole/cleanout ;;>-/oo
Petroleum tank HoNE
~¢ ,m4,/./ Other bacteria 0 ~of ~'/c,o~¢'_
Collected by: FL4-'Ffo? T¢C~/. 5¢CS.
B. SEPTIC/HOLDING TANK DATA
Date installed (~
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping <8/2°1/Cl3
Tank size
Foundation cleanout (Y/N)
dA/_ Compadments
¥ Depression (Y/N)
Alarm tested (Y/N)
Pumper
N
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot
To property line
Surlace water/drainage
On adjacent lots ~ Ioo~
Absorption field /G
'~- Io~
Foundation / 6
Water main/service line
72-026 (3/93)° Front CONTINUED ON BACK PAGE
C. LIFT STATION N,,4.
Date installed
Size in gallons
Vent (Y/N) "Pump on" level at
High water alarm level
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
Well on lot
D. ABSORPTION FIELD DATA
Date installed ~ [2-z
Length 5'~i Width
Total absorption area
Date of adequacy test 7/'7/ff 3
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
On adjacent lots
Surface water
Soil rating (GPD/Ft2) I, '2.
Gravel thickness
Cleanout present (Y/N) "/
Results (pass/fail)
System type TR~¢C H
8 ' Total depth Il/
Depression over field (Y/N)
~'/~SS for G After test 3~"
If yes, give date k(, A ·
N
Bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
I
Well on lot 2 1 -/
To building foundation
On adjacent lots '~
Surface water > ldo'
Curtain drain ~o~ o~sE~v~b
On adjacent lots '>/oo Properly line
To existing or abandoned system on lot
Cutbank KL/~, Water main/service line
Driveway, parking/vehicle storage area
E~ ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in ?,E..e, ct. on the date of this inspection.
EngineeCs Name
Date ~ ly iii
HAA Fee $ ..~4~4¢
Date of Payment "~-
Receipt Number
72-026 (3/g3)° Back
Waiver Fee $
Date of Payment
Receipt Number
07/'11/94 11:41 CT~E ENUIRONHENTRL LAB SERUICES -~ 3451355 N0.509 [~L3>]
CT&E l~f,#
Cli~ll S~mipl~
Mu~rix
Commercial Testing & Engineering Co.
Environmental Laboratory Services j,~rj~'~r~rj~r~r~'~r.~,-jj~r~rf.~.~jjj~ff~~
LABORATORY ANALYSIS REPORT
94.3412-1
1,10 BLK2 LFLAC PARK WEST HOSE 1111]
WATER
Client Nanlc FLATI'OP 'i'ECItNICAL SI),V WORK Order 80162
Ordered By TED MOORE, Printed Dale 0W11/94 (.(_0, 11:26hrs,
Project Nmae Collectcdgatc 07/07/94 ~¢J 13:15 hrs.
Project# ReceivedDate 07/07/94 (c.'~ 14:00 krs.
Pwsm uA
Technical J.~irector STEPHEN C. EDE
QO A.11.owable Ext. Anal
Parameter Results Qual Unils Method Limits Date Date
--~;;t~:~ ............................ ---~',~ ..........
* S¢0 Spouiul ltl/~tru~tion.q Above UA = Unawd. l~l e
* * Sec Sample Remat'ks Above ~ = Not ~).alyzed
. U= Utt<~t~te{ Rq>m~edvalm is thcpractical qg~nfification limit. LT= I~ss 'lhan
~ D = S~on&try <~ll~ion. Gf= (~'eater~mn
5633 B Street, Anohorage, AK 99b~8.t600 -- Tel: (907) ,562-2343 Fax: (907) 661-5301
~NViRONMENTAL FA~ILITI~S IN A~SKA, COLORADO, FLORIDA, ILUNO~S. MARYLAND, NEW J~RSEY, OHIO, UTAH, WEST VIRGiNiA
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
01521134 HAA#
GENERAL INFORMATION
Complete legal description
Lilac park, Lot 10, Block 2
Location (site address or directions)
Property owner
Mailing address
Mary & Gary Cartwright Day phone 563-3032
10231 Spinnaker Drive, Anchorage
Lending agency
Mailing address.
Day phone
Agent
Day phone
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
individual well
Address
Unless otherwise requested, HAA will be held for pickup.
Hold for P/U by Mountain Engineering
6
NOTE:
X
Community well
Pdblic water
If community well system, provide written confirmation from State ADEC attest..
lng to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
NOTE:
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) Fronl MOA #21
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 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.
Name of Firm Mountain Engineering
Address 3868 Shannon Circle, Anchoraqe,
Engineer's signature
DHHS SIGNATURE
.A/'~' Approved for
Disapproved.
bedrooms.
Conditional approval for
Phone 562-1500
AK 99518
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Sen/ices (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 MOA/~21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescription: Lilac Park, Lot 10, Blk 2 ParcelI.D. 01521134
A. WELL DATA
Well type Private
Log present (Y/N)
Total depth 183
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed 12/22/83 _Driller
Cased to 17~. ~ Casing height
Y ~' Wires properly protected (Y/N) Y
M-W Drilling
30"
FROM WELL LOG AT INSPECTION
Date of test 12/22/83 °l (IH'(~Z
Static water level 123 ' ( '2- ~- i
Well flow 80 g.p.m. ?, 2
Pump level Unknown Unknown
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 185 '
Absorption field on lot 217 '
; On adjacent lots 160 '
; On adjacent lots 1'75 '
Public sewer main NONE
Public sewer service line
WATER SAMPLE RESULTS:
Coliform 0 ~
Date of sample:
NONE
Public sewer manhole/cleanout
Petroleum tank
NONE
NONE
9/14/92
Nitrate
g.p,m.(limited only
by pump size)
· 32 .-' Other bacteria 0
Collected by: Mountain Engineering/BE
B. SEPTIC/HOLDING TANK DATA
Date installed 6/26/92
Cleanouts (Y/N) Y '~
High water alarm (Y/N)
Date of pumping New
Tank size 1,750 Compartments 2
Foundation cleanout (Y/N) 7' Depression (Y/N)
N/A Alarm tested (Y/N) N/A
Installation
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 185 '
To property line 54'
Surface water/drainage
On adjacent lots
Absorption field
NONE
150 ' Foundation
Water main/service line
16'
90'(on &or)
72-026 (Rev, 3/91) Front MOA 21 CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed NONP
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Man ufactu rer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed 6/27/'92
Length 59' Width 3'
Total absorption area 944 SF
Soil rating 1.2 GPD/SD System type Trench
Gravel thickness 8 ' Total depth 11.5
Cleanouts present (Y/N) ¥ ~
Depression over field (Y/N) Nope
Date of adequacy test
Results (pass/fail) Pass
for 6 ~
bedrooms
Peroxide treatment (past 12 months) (Y/N) NO
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 217' On adjacent lots 123'
To building foundation 47 '
On adjacent lots GT 50'
Surface water NONE
Curtain drain NONE
Property line 53 '
To existing or abandoned system on lot ~TONE
Cutbank NONE: WateCmai~/serviceline 90 ' (on
Driveway, parking/vehicle storage area CT 50 '
lot)
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inst~ection.
Engineer's Name Mark Pearson /,~.E~ ....... l..~~~
Date 9/19/92
' ~¢~. %. CE- 7760
HAA Fee $ / '"~(~
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number