Loading...
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 . 4 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 V c�� �2 PERMIT NUMBER: RECORD DRAWING PARCEL NUMBER: OSP231280 015-211 1-34 l 1 •/ '—' 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 i I I I i I r i r r r r EXISTING J HOUSE / r NEW 1500 GALLON SINGLE I COMPARTMENT GREER TANK4\ FC U / NEW 1000 GALLON SINGLE QU / COMPARTMENT GREER TANK, I I I ,� 11 c J I 1 I I r i I 1 I I I T I 1 I r � I / I 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 A N r1= 40' 1 ff# y A. Carnee A #o CE.7953 i LICENSE#�4 a ES1s'� �••• #AECC884 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 .Mldwo woolm 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 —3�j 'A 41 00+ LLJ CL s r Z a► z z< 41 < -J LIJ,r CO =a • a. w Ljj• z r U43 • V. • 0 o o s 0 CL E 0 .0 MM ;e � 9 I0 i• '';$ 0 k .;. Y. �.5 `3 OR O d fit. �,^ , a ■$ .r rt jg' IL 'Tool ! r U) LIJ Zm.., F j� 8 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 T' $� %....:.... Ji A,, Corn ss: LE_ 7 9 �J Cyp LICENSE r Of e s #AECC8 ci 1-1 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