HomeMy WebLinkAboutLAKE HILL ACRES #5 BLK 1 LT 7LAKE HILL ACRES #5 BLOCK LOT 1 051-122-12 Survey requirement waived in order to close out OSP221219. A new survey will be required in the future for field upgrade or COSA. Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221219 PID Number: 051-122-12 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name SAMUEL BRUSER TION FIELD rn[E:]De TrenchEl Wide Trench El Bled ound Site Address 22454 HILLTOP CIRCLE, CHUGIAK, AK 99567 Other Phone Number of Bedrooms Soil RatingTotal depth f original grade 907-570-4946 4 /sF Ft. LEGAL DESCRIPTION Depth to pipe invert from original a Gravel depth beneath pipe EXISTING Subdivision Block Lot LAKE HILL ACRES #5 1 7 Ft. Fill added above original gr a Gn1l h Ft. Ft. Township Range Section - - Gravel width Ft. Beds: Number of Lines Dist a between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between ches From Tank Field Tank Line Ft' - Well *50'+ EXISTING *50'+ _ 25�+ TANK ❑■ Septic 0 S.T.E.P. ❑ Holding ❑ Other Manufacturer INFILTRATOR SYSTEM Capacity 1060/540 Gal. Surface Water *50'+ EXISTING *50'+ _ Material Number of compartments Lot Line 5'+ EXISTING 5'+ - NA PLASTIC Foundation **10'-1- EXISTING **1 01+ _ LIFT STATION Manufacturer INFILTRATOR WITH AFROQFLL COMPONENTS Capacity 475 Gal. Remarks *THIS IS AN AWWTS **9'+ TO RETAINING WALL. SEE NORTHERN GEOTECHNICAL Alarm location IN HOUSE Electrical installed by ENGINEERING EVALUATION REPORT (DATED 9/1/22). Installer PIPE MATERIAL House to tank D3034Tank to D3034 drainfield ARM SERVICES, LLC Drainfield EXISTING CO/MTD3034 Inspector GEG CONSULTANT, JODY MAUS BENCHMARK (Assumed elevation) 100.00 ft Inspection 1,ectio1 10/11/22 2nd 10/12/22 Location and description 31d 10/17/22 4" - LOWER MAN -DOOR THRESHOLD ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's $tamp op60 Conditional Approval: Date�� 4*�p0" ....:. .. ........ ............ '. �..........� Op Garrless, d�9 / CE -795 p0 P Septic System Approved Date- = �z Note: this approval does not include well permit requireme ts. e F,� o Yprcfessooa= #AEcceaa4 tRCV vuluU 10) NORTHERN GEOTECHNICAL ENGINEERING, INC, ./ TERRA FIRMA September 1, 2022 NGE-TFT Project # 6445-22 Sam Bruser 22454 Hilltop Circle Chugiak, Alaska RE: ENGINEERING EVALUATION AND RECOMMENDATIONS FOR THE PROPOSED EXCAVATION AND INSTALLATION OF THE SEPTIC TANK ADJACENT TO THE FOUNDATION OF THE RETAINING FALL AT 22454 HILLTOP CIRCLE — CHUGIAK, ALASKA Sam, We (Northern Geotechnical Engineering, Inc. d. b. a. Terra Firma Testing) have reviewed the proposed installation of a new septic system tank that will be located near the foundation for the retaining wall on the above referenced site. • The tank is expected to be about 5 to ld feet from the wall and the base of the tank will be about 7 feet below grade. • The tank is about 10 feet long. + The base of the retaining wall foundation appears to be at least 2 feet below grade. Soils are dense, based on a shallow excavation used to try and determine the foundation depth. It is my opinion that the proposed tank location will not impact the retaining wall during construction. We do recommend that the tank installation be planned to minimize the time the excavation is open. Once backfilled, the retaining wall will not induce any significant load on the tank. We greatly appreciate the opportunity to provide you with our professional service. Please contact us directly with any questions or comments you may have regarding the information that we present in this Ietter, or if you have any other questions, comments, and/or requests. Sincerely, Northern Geotechnical Engineering, Inc. d. b. a. Terra Firma Testing Keith F. Mo E. President 49 :.': . Keith ftley i CE - 5666Aw PROFESSIOH��� Page 1 of! 11301 Olive Lane Anchorage, Alaska 99515 • p6orte, t (9,7) j 44 _5934,Ff'071 ?$d taaI I. trr_t .1. PERMIT NUMBER:C PARCEL ID NUMBER: OSP221219 RECORD DRAWING 051-122-12 NEW IM1060 INFILTRATOR Tf INSTALLED DOUBLE CLEANOUTS (DBL1 & DBL2 EXISTING CONCRETE BLOCK RETAINING WAL N SCALE: 1•=20' r r 50' SETBACK / FOR AW WTS / / INSTALLED DOUBLE NEW IM540 INFILTRATOR CLEANOUTS TANK EQUIPPED WITH (DBL3 & DBL4)—\ / / QUANICS COMPONENTS / / / / J J J 100' WELL RADIUS NOTE: PER THE CONTRACTOR, THE OLD BIOCYCLE UNIT WAS FILLED WITH CONCRETE. THE OLD 1996 DRAINFIELD WAS FOUND TO BE SIGNIFICANTLY OUT OF LEVEL AND NOT CODE COMPLIANT. PER THE CONTRACTOR, THE1996 DRAINFIELD WAS DECOMMISSIONED IN PLACE. NEW 4' SEWER LINE INSTALLED FROM AERCOCELL UNIT TO DRAINFIELD PER EXISTING 4 -BEDROOM HOUSE XISTING 2019 DRAINFIELD _— ------ i i 50' WELL RADIUS FOR AW WTS 0 B ........ "rr ENGINEERING -SALES CONSULTINGs• 3701 E. TUDOR ROAD, SUITE 101' ANCHORAGE, ALASKA • PHONE (907) 337-6179' WEBSITE: www.gamessengineodng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I® fir,+ SAMUEL BRUSER 907-570-4946 2 OF 3 PROJECTILEGAL DESCRIPTION: DRAWN BY: LAKE HILL ACRES #5; BLOCK 1, LOT 7 J.L.M.4?� TYPE OF WORK: DATE: E RECORD DRAWING FOR SEPTIC SYSTEM UPGRADE 10/28/2022 # LICENSE 4 —EXISTING SEWER LINE ENTERED AT END OF DRAINFIELD PER CONTRACTOR -NEW NS500AC AEROCELL UNIT ��� DBLI 23.8 40.7 DBL2 23.9 40.3 MH1 24.5 33.8 ST1 26.0 30.1 DBL3 27.0 28.8 DBL4 27.4 28.4 MH2 29.3 26.9 VP1 18.5 1 42.8 POD1 - 20.6 38.4 VP2 24.6 37.4 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. C 7951 +•........••.. a®ISt,, 0 Municipality of Anchorage S� g P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On-Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231012 COSA#: Permit#:OSP221219 PID#: 051-122-12 Legal Description: Lake Hill Acres #5 Block 1 Lot 7 Engineer: Garness Engineering Group Your request for a waiver of the required 20 feet maximum segment length for an Advanced Wastewater Treatment System has been approved. The approved length is 28 feet. This waiver approval applies to the existing Error! Reference source not found. only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Grant d: Date: 7'3 Approved by: Name of Reviewer **** VARIAN C E/WAIVER REVIEW **** a a lcs r.��x.- rw:,.rr,;�z, _..ess....:s.,..�_�.,._.<_M .;��.' N.; -v.-r��.�...�.,.�—:.._,..�r-.,., ..Y."�r: GARNESS ENGINEERING GROUP,Int A oefl- =v�,: ENGINEERING- SALES �� CONSULTING Alaska Authorized Dealer March 16, 2023 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Attention: Curtis Townsend, PE Ref: Drainfield Segment Length Waiver Request for Lake Hili Acres #5; Block 1, Lot 7 Mr. Townsend A septic system upgrade was performed recently at the referenced property, and record drawings were submitted to your department. Upon review, you noted that the sewer line entered the east end of the drainfield, rather the center of the drainfield, as shown on the 2019 record drawing, and on the approved 2022 design/permit. The 2019 drainfield is installed with less then 4 feet of vertical separation to groundwater; therefore, per code, no segment of the drainfield lateral should be longer than 20 feet. The total trench length is reported to be 28 feet, so it is reasonable to believe that the total length of perforated pipe is around 26 feet. The 4 -inch gravity line from the Aerocell treatment unit should have connected no closer than about 6 feet from either end of the perforated pipe in trench. We are requesting that a waiver be granted, allowing the distribution line to be connected at the end of the drainfield. From a practical perspective, there is no increased risk to public health, or the environment. If you have any questions, please contact me at 'V17 _R17_Q M.S. 3],-1 /z.3 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com TOP OF TANK @ INLET = 91.7 INVERT @ INLET = 91.1 0 oil '01111111 1 Lool. NMI FINAL GRADE TOP OF MH1 = 94.03 = 94.39 STI 2" OF INSULATION TOP OF TANK OVER TANKS PER @ OUTLET = CONTRACTOR—\ 11 91.71 INVERT @ INLET = 90.73 TIMED CONTROL PANEL TOP OF TANK @ INLET = 91.35 - IM -1060 SINGLE COMPARTMENT INFILTRATOR TANK IM -540 INFILTRATOR TANK FINAL GRADE = 93.99 TOP OF MH2 = 94.42 HOLE PARCEL ID NUMBER: 051-122-12 REMOTE MONITORING SYSTEM UNIT INSTALLED IN HOUSE 4" BY 4' WIDE RIGID INSULATION CENTERED OVER PIPES PER CONTRACTOR °�ia►0W! •- OF OUTLET = 91.31 ---INVERT @ OUTLET (RETURN) = 90.76 TIMER OVERRIDE FLOAT HIGH WATER FLOAT ON/OFF FLOAT GOULDS PE51M EFFLUENT PUMP —2 - 8" CONCRETE CINDER BLOCKS FOR PUMP PEDESTAL 1 QUANICS NS -500 -AC AEROCELL POD 4" DISCHARGE (20%) TO DRAINFIELD— TANK FLOAT SETTINGS INFILTRATOR TANK MODEL IM -540 TOTAL CAPACITY 552 GALLONS WORKING CAPACITY 475 GALLONS INLET INVERT 44" OVERRIDE FLOAT 34'(-42-) HIGH WATER ALARM 32" *40'° ON/OFF FLOAT 20" *28" FLOAT LEVELS ARE FROM BOTTOM OF PUMP (*MEASUREMENT FROM BOTTOM OF TANK). NOTE: MEASUREMENTS ARE WHERE THE FLOAT WIRE ATTACHES TO PIPING WITH A 3.5 INCH TETHER FROM PIPING TO FLOAT. ALL FLOATS MUST BE NARROW ANGLE FLOATS. Iz LU U) � t0v U- 0 g r- may N Q wo ZLL O In co q,U) z0) wV) Z- �-x o tilt a a a o 0 y s� i Ore O� W Lu. �$ U Q W Frg O >_ U) x U a Z' O J W c o a a m LL O S Lgj t9 W W U o� mWO oY ` ,a A 0W w� OF iv ...... .. ............. .. a•r° .. die#•r...............e e wr uanics 0. �ney . mess a j'� C -795 9 r ,As ska Authorized Dealar LICENSE it YA S te" #AECC884 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PoBox 1ussso 47ooElmore Road Anchorage, Alaska yno1e-ooso Phone: rocw rax: (907) 343-7997 Permit Number: OSP221219 Work Type: SepUoTankUpgrode Tax Code Number: 05112212000 Site Legal Address: LAKE H|LLACRES #5 BLK 1 LT 7 G: 1562 Site Mailing Address: 22454HILLTOP C|R.Chugiak Owner: 8RUSERSAMUEL T& Design Engineer: GARNESSENGINEERING GROUP LTD This permit iafor the construction of: [] Oiop000/ Field 0 Septic Tank [] Holding Tank [] Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 7/1/2022 7/1/2023 []Private Well [] Water Storage All construction shall beinaccordance with: 1. The attached approved design. 2. All requirements specified inAnchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (1OAAC72)and Drinking Water Regulations (18AAC8U) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.05.Provide notification bycalling (9O7)343'7QU4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: m. Opened and Closed onthe same day, or b. Covered, sealed, and heated toprevent freezing Special Provisions: � ^ The 1QQGpermit was not closed and the trench ionot documented. Document the field inorder to �. connect Kbnthe Duanicmsystem. Receive B) Issued By: 7 // I )_ ---� ILI MUNICIPALITY OF ANCHORAGE Development Set -vices Department Phone: 907-343-7904 On -Site Water c, Wastewater Section_ a,.. 907-343-7997 7997 ON-SITE SEPTICMELL PERMIT APPLICATION Parcel I.D. 051-122-12 Property owner(s) SAMUEL BRUSER Day phone 907-570-4946 Mailing address 22454 HILLTOP CIRCLE, CHUGIAK, AK 99567 Site address 22454 HILLTOP CIRCLE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) LAKE HILL ACRES 45; BLOCK 1, LOT 7 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank 0 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN Initial ❑ Upgrade x❑ Renewal ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: TYPE OF DWELLING: Single Family (SF) x❑ (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) 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:aa 5 Waiver Fees: Date of Payment: .2.2 ,;1 D,) 2 Date of Payment: Receipt Number: 08 1 � 56 Receipt Number: Permit No. _ 0 SF12 �2 Q % 5 Waiver No. GMevelopment Services\Building Safety\On Site Water and WastewaterTormMClient Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221219, Deb Wockenfuss, 07/01/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221219, Deb Wockenfuss, 07/01/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221219, Deb Wockenfuss, 07/01/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221219, Deb Wockenfuss, 07/01/22 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW Date of Issue Parcel Identification Number: Legal Description Property Owner Name & Address Lake Hill Acres #5 Block 1 Lot 7 Sam Bruser 22454 Hilltop Circle Chugiak, AK 99567 Pump Installation Date: 5-24-22 Pump Intake Depth Below Top of Well Casing: 270 feet Pump manufacturer’s Name: F&W Pump Model: 4F11P10301S Pump Size: 1 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Unknown Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Unknown Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 191269 PID Number 051-122-12 Dwelling: 0 Single Family (SF) ❑ v,rith ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Westlund ABSORPTION FIELD ❑ Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound Site Address 22454 Hilltop Circle ❑ other Phone Number of Bedrooms Soil Rating Tolal depth from original grade 250-4996 4 4 GPD,+SF 4.5 Ft. LEGAL DESCRIPTION Depth to pipe invert frorn original grade 3.5 Ft. Gravel depth beneath pipe 1 Ft. Subdivision Block Lot Lake Hill Acres #5 Block 1 Lot 7 Fill added above original grade 1 ;d lGravet length 28 Ft. Township Range Section Gravel width 5 Ft.l Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES ToiTotal Septic Absorption :Lift Station Holding Seaver absorption area Number of trenches Dist, between trenches From Tank Field Tank Lino 161 F(2 1 Ft. Well 100'+ 00'.� 00'+ na 51+ TANK l] Septic [JS.T. E. P. [) Haiding X Other Manufacturer Capacity Biocycle 1500 Gat. SurfaceWpter 50'+ 501+: 50'+ na Material Plastic Numbor of compartments 2 Lot Line 10'+1 81+ 104 Ila I NA Fouridation 11o'+1 10'+ 10'+ na LIFT STATION f�tanufaeturpr Biocycle Gapaciby 1500 Gal. Remarks Lot Line Waiver & Well Waiver .Alarm location Side of House Electrical installed by Biocycle Installer PIPE MATERIAL House to tank Tank to Sch40 drainfield Dean Drainfield D3034 co/WIF D3034 Inspector BENCH MARK (assumed elevation) 100 ft Inspection 8/7/19 8112119 Location and description dates: 2`1 Deck 3"' 411'. ON-SITE WATER AND WASTEWATER SECTION APPROVAL OF Conditional Approval: Date ,.....49TH ,/ Septic System - n Steve Eng ko Approu ( Date � Z CE ' -6x56 i v Note: this approval does not include well permit requirements. 11 / 70 1 N.rI-, _r D 1 11 1AWI- VV_vv I % � J—I vv - U I - —R:;- v-v•y co MT/CO DV NOR THRIM -`--: `4k4 LAKE HILL ACRES #5 1� = 40� ENGINEERING Y*�? *,y SteveEng.com , f v! BLOCK 1 LOT 7 RECORD PO Box 770724 f Eagle River, Alaska 99577 `4'11/11/20 WASTEWATER UPGRADE LAYOUT 907.694.7028 NEW TRENCH °°ts` 11/11/20 2 of 3 I W \ a U �\ n V) h-� O Unsubdivided S 00'06'00"E 361.43' x 0 m Uf w 162.10' 1 0 0 al U L- 0 Q� V) •O o0 f� J "4, O •0 0 L - 0 y V CL I ..ro C a a. a r' c ° 00 0 O m Z E a C •a- gmcm`> 4 c m O ,a 0 . Z V) O 0 O no v cl0.2.1 a o a 0- c c a a = C C. 0 O in Q• 09 0 c G o Et" iy0�m O m Of a9 z 0 r' E z GOr 00�m -1 Ji C y 0S m O m 0. a s O mL o c ..0 C a s 1 09 � a �aao� o -IQ� O O O m G 0 o O m p m 0c�►- o >La 0C -0C m of m m C. _ ��c + m & 0 000 ► O t69 J09009.ac � mmw EEc0 U m��00> a q itl h.�+ m CD c t m Q cS CL 0 E E m O L O y_ tQ$ c mo in c� mQ E� O p 0 my C •a a o 0 ° 0 m 0 T `o .90 JU 0 m m o m t c 00 c L m 0 a m a d O c c a 3� O O Wt = ; 0 zY J Lno V �z 0 z M O N U NU 0 , x In 6� W ,� m W (/) o�do� �� QT J.. o z c\ 2 Na. U L- 0 Q� V) •O o0 f� J "4, O •0 0 L - 0 y V CL I ..ro C a a. a r' c ° 00 0 O m Z E a C •a- gmcm`> 4 c m O ,a 0 . Z V) O 0 O no v cl0.2.1 a o a 0- c c a a = C C. 0 O in Q• 09 0 c G o Et" iy0�m O m Of a9 z 0 r' E z GOr 00�m -1 Ji C y 0S m O m 0. a s O mL o c ..0 C a s 1 09 � a �aao� o -IQ� O O O m G 0 o O m p m 0c�►- o >La 0C -0C m of m m C. _ ��c + m & 0 000 ► O t69 J09009.ac � mmw EEc0 U m��00> a q itl h.�+ m CD c t m Q cS CL 0 E E m O L O y_ tQ$ c mo in c� mQ E� O p 0 my C •a a o 0 ° 0 m 0 T `o .90 JU 0 m m o m t c 00 c L m 0 a m a d O c c a 3� O O Wt = ; 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.6rg/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191269 Work Type: Septic Upgrade Tax Code Number: 05112212000 Site Legal Address: LAKE HILL ACRES #5 BLK 1 LT 7 G:1562 Site Mailing Address: 22454 HILLTOP CIR, Chugiak Owner: WESTLUND RICHARD D & SUSAN K Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: ���il,ent a Department Lot Size in Sq Ft: Total Bedrooms: 7/18/2019 7/17/2020 24533 Q Disposal Field ❑ 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 Special Provisions: 1. A test hole shall be provided prior to construction of the drainfield to confirm the required 4 ft minimum separation to bedrock is met, as well as to confirm the percolation rate of the accepting soil(s). If results require a design change, construction shall stop pending Onsite review and approval of a change order. Please submit results of the test hole with the inspection report (or change order, if required). 2. An inspection report and record drawings for Permit SW960009, under which the existing BioCycle and drainfield were installed, were never submitted to close the permit. The inspection report and record drawings for this permit shall also document the installation of the system that was installed under Permit SW960009. Received By: Issued By: Date: -711e Date: 7 ✓� / n M Municipality of Anchorage \;..tib%/ L cparnnent P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 o Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV191058 COSA#: Permit#:OSP191269 PID#: 051-122-12 Legal Description: Lake Hill Acres #5 Block 1 Lot 7 Engineer: North Rim Engineering Applicant: Richard & Susan Westlund Your request for a waiver of the required 5.0 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 1.0 feet. See engineer's waiver request letter for justifications. This waiver approval applies to the proposed absorption field only. Any fixture upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ■■MMUNM0MK0MNKMMxxMMxK0aMaMMNMax0xxUaMMaaMM0aMMxMKNKxNaxM0MNMM2xMMM.axNMaMx0MMI Waiver is Granted: X Waiver is not Granted: J Date: r/ 1 f I f j r Approved by: I��Q ��r( C('l� ��; ?,tom Name of Reviewer ■��M0MxxxKKM0aKMNKMMaxMKKKN.MMNKMKMNKMZMxMMKKKMatxMNaMMMa0MMNKIt0xaMKMt0aaN1.MaMI **** VARIAN C E/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section --f' Fax: 907-343-7997 rb\1�67 8 9 70� ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-122-12 Property owner(s) Westlund Mailing address 22454 Hilltop Circle Site address same 2019 3 ti Day phone 250-49 r 9 �n CQ Legal description (Sub'd., Block & Lot) Lake Hill Acres #5 Block 1 Lot 7 Legal description (Township, Range & Section) Lot Size 24,553 Sq. Ft. Number of Bedrooms Ll APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial El Single Family (SF) (w/wo ADU) Septic Tank ❑ Upgrade Fx] Duplex (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: C) 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: 5q6' Waiver Fees: o� 5 Date of Payment: 6/2 Date of Payment: Receipt Number: 06-ga. ) Receipt Number: y Permit No. J5/a/19420 Waiver No. nSy 1 9 1 d 5 Y GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Clie nt FormsTermit Application.doc SteveEng.com Lake Hill Acres #5 Block 1 Lot 7 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 4-bedroom, single family home. An existing Biocycle is functioning, but the trench is failing. A new shallow trench is planned. A design is submitted for a new trench & diverter valve to old trench. The neighboring lots are developed as indicated in the drawing. The easements are located on the drawing and are not encroached upon. Neighbor lots are served by septic systems and private wells; there are no conflicts. The topography generally slopes north toward Mirror Lake. One steep short slope exists on northeast side of house. The property to the east is a large tract with Boy Scout camp- no conflicts. The slope is minor and can be graded for lesser final slope. A Category II application rate of 4 GPD/FT². Trench Length = 150/5' x .87 reduction factor = 26.1'. A new rest hole can take place at construction to confirm depth to bedrock. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. Connect new trench to existing Biocycle. 1’ minimum between the trench & line- waiver. 2’ of cover is required for trench + 1 inch insulation board. Solid pipe must be set on well compacted, stable soil All cleanouts must extend to at least ground level Trench to be placed level, minimum of 4’ to groundwater, 6’ to bedrock from drain-rock Drain rock to be ½ inch to 2 inch screened. Drain rock to be distributed uniformly throughout the trench. 4 inch diameter cleanouts with airtight caps are required 1’ to 4’ from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10’ from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Perforated pipe to be installed level with perforations down. Silt barrier (filter fabric) to be installed above the drain rock The finish grade must be mounded to promote drainage away from trench. Smeared trench sides must be raked or scarified before drain rock placement Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. Sewer Service Line is minimum 2% slope Septic Tank to be pumped every two years or when required Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) Maintain minimum 10’ separation between water line & wastewater system. x �T� GINEERING Date: 7/17/19 To: MOA On -Site Services Steve Eng, PE, PH 907-691-7028 SteveEngPE@amail.com Subject: Lake Hill Acres #5 Block 1 Lot 7 Lot Line Waiver Request Number of Pages: 1 A design has been submitted for a new trench for subject property. The plan drawing previously submitted depicts the close proximity to the east lot line. This waiver is necessary due to: • This is the location of the current septic system. In order to utilize the existing trench for a future replacement site, best fits this location. • The previous test holes were located at this site- best to design from • The advanced wastewater system provides superior effluent quality- lesser impact. • Adjacent property owned by Boy Scout camp. This large land tract is not impacted adversely by the lot line waiver. Please issue approval so owner can get functioning system. Thanks -Steve OF * -9 J `ro .. �Steea•Eu9 Vw Rick Mystrom, Mayor Mun cipal ity of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 January 17, 1997 Richard D Westlund 22454 Hilltop Circle Chugiak, Alaska 99567 5708 Subject: Lot 7 Block 1 Lake Hill Acres Subdivision #5 Permit #SW960009, PID #051-122-12 The subject permit, issued January 17, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of January 17, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation'. Ail inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. am~ee~rec~rlY ' Program Manager On-site Services enc: Copy of Permit cc: Criterium Alaska Engineers P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW960009 DESIGN ENGINEER.C U q OWNER NAME:WESTLUND RICHARD D OWNER ADDRESS:22454 HILLTOP CIR CHUGIAK, ALASKA 99567 5708 PAGE 1 OF 1 (UPGRADE) PERMIT DATE ISSUED: 1/17/96 EXPIRATION DATE: 1/17/97 PARCEL ID:05112212 LEGAL DESCRIPTION: LAKE HILL ACRES #5 BLK 1 LT 7 LOT SIZE: 24533 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 (18AAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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: THE WASTEWATER DIS~P/DSAL SYSTEM INSTALLED UNDER THIS PERMIT IS AN ALTERNATIV~/~S~STEM LL~DERGOING EVALUATION WITHIN THE MUNI CI PAL I TY- ~~////~/ / /~/~ RECEIVED BTf:/ ~,/% / c~,~,' ~ ~ __ DATE: · P.O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907 349-1003 IN AK 800 478-1003 FAX 907 344-9936 RECEIVED December 18, 1995 Munic~pahty ot Anchorage Dept. Health & Human Services Mr. Jmnes Cross, P.E., Program Manager On-Site Services, Water Quality Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 Reference: On-Site Septic System Upgrade, Lot 7, Block 1, Lake Hills Acres 22454 Hillto Circle)~:~ Chugiak, AK, CAE Job 4/95973 Dear Mr. Cross: Enclosed arc the drawings outlining the upgrades we are proposing for the failed on-site system on the above-referenced lot. You will note that this upgrade incorporates a biocycle aerated wastewater treatment system. Because of this innovative system, we are recommending that waivers be granted for the well to drainfield separation distance, proximity of the drainfield to steep slopes, and proximity of the biocycle tank to surface waters. The existing system consists of a 750 gallon steel tank and 86 linear feet of drainfield. From our investigation, we have concluded the tank is rusted through and the dralnfield is completely plugged. In addition, the tank is within the 100' well radius and the dralnfield within the 100' setback from Mirror Lake. A foundation and retaining wall have also been constructed over the drainfield. It is apparent that the septic tank is effectively acting as a cesspool and little, if any, effluent was reaching the drainfield. Since we initially investigated the system in late September, the outlet of the tank has been plugged and the Westlunds have been pumping the tank about every two or three days. Because of the site constraints, i.e., well radius, slope, surface water setback and shallow bedrock, very little usable area is available. We have designed a system that optimizes what usable area there is, but even with the reduction in drainfield size, due to the polished effluent from the biocycle, a well to drainfield waiver is necessary. The well is a deep well some 302' deep, bedrock starting at 9' below the surface. We are of the opinion the naturally impervious bedrock will adequately protect the water supply. In addition to the biocycle being within 100' of sm:face water, a portion of the drainfield will be within 100' radius of the well. The drainfield will encroach 14' into the radius; however, the elevation of the dralnfield is some 10' below the elevation of the well head. The alternative to placing the drainfield within this radius would be to encroach further on the setback from the top of the nearby slope and encroach on the 100' surface water setback. REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEERING LITIGATION SUPPORT CONSTRUCT[ON MANAGEMENT · Mr. James Cross, P.E. December 18, 1995, Page 2 We are of the opinion that the surface waters and the water supply will be adequately protected, as the effluent from the biocycle system is effectively a treated effluent. The effective size of the drainfield has been reduced to an application rate of 4 gpd/sf.. This reduction is reasonable because of the treated effluent, the quality of the receiving and the site limitations. We recognize that this design deviates in many instances from' regularly accepted standards. We are also of the opinion, however, that this is the type of installation that rite biocycle is ideally suited for. Therefore, we request that you approve this permit application and issue a permit for the installation of this system. We do request that you give this your immediate attention, as we are trying to accomplish the installation of this system for the safety of the occupants of the residence as soon as possible. The proposed drainfield is located in an area which will not affect nearby wells on adjoining properties. This propos ,ed system will have no deleterious effect on existing on-site systems on adjacent properties. This proposed upgrade is to replace an existing sub-surface system. There are no known reservations other than for upgrading an on-site sub-surface system. Drainage is generally to the north away from the proposed drainfield. Surface slopes are adequate to allow proper drainage away from the location of the proposed field. We appreciate very much your cooperation, and ff you have any questions, please do not hesitate to comact us. TAJ/jbj/Enclosures ___x \Lr'x , Var]es, .)¢::;,'.:(,-]04"~ ~.lev -~ 54,0' %? of' PiOCulcle 54,0: ~ i .Sill (Hoase) IOO: NT5 MT /,Al' CO CO PERFORMED FOR:_ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchora. ge, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST LEGAL DESCRIPT$ON: ",: "' 7 8 9 10 11 12- 13 14 15 16 17 18 19 · 20 , , ,: · .. Township, Range, Section: ~ ,;: [._ , .':~:.,/-> ;. SLOPE ;..: .,i ,, F'i ,I, I WAS GROUND WATER ENCOUNTER EO? IF Y55, AT WHAT DEPTH? SITE PLAN Water Ailer ~0nitorin~l? . Date: _,_ Gross Net Re~ding Date Time Time TEST RUN BETWEEN COMMENTS Depth to Net Water Drop (minutes/inch) PERC HOLE DI;AMETER -- · FT AND _ FT PERFORMED BY: I CERTify '['HAT THIS TEST WAS PF. RFORMED iN ACCORDANCEW,THALLSTATEANDMUNICIPALGUIDELINE$INEFFECTONTHiSDATE' DATE: 72-008 (Rev. 4/~5, PERFORMED FOR: 2 9 16' 11 12 13 14 15 17 18 19 20 Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST -. .~ ¢.., ,.-, Township, Range, Section: LEGAL DESCRIPTtON:~7'4 ~/') I~..,~ SLOPE ~... :/~ - ' , .... ' . , . , , ' COMMENTS ,Z~,~-F SITE PLAN WAS GROUND WATER ',%1 ~ iF ,'ES. AT W AT i j DEPTN? i~Owa ~ ~ Oepth to Water A~r ~/~ ..... Net ~rop Reading I Date Net I De,otb to Time Water I "~-~ I I , I I~" ~' '-II _ u] ! z,¢" ~.¢" I ', 'i 't I ' } I ,¢,', ,1" ' 't ' 8' PEROOLATION RATE . TEST RUN BETWEEN , % ~ 'L) ~ ~ . FT AND FT ,?o ~ PERFORMED BY: ~S ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) TiFY THAT THIS TEST WAS pERFORMED IN Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 January 18, 1996 Ted Johnson, P.E. Criterium Alaska Engineers PO Box 111790 Anchorage, Alaska 99511 Subject: Waiver Request for Lot 7 Block 1 Lake Hill Acres ~5 Waiver Request ~WR950070, PID ~051-122-12, SW960009 Dear Mr. Johnson: Your request for a waiver(s) of the required 100 foot horizontal separation of a septic system to the surface water and a septic system to aprivate well have been approved. The approved separation distance(s) are the biocycle tank to the surface water of 75 feet and the private Well to the drainfield of 86.6 feet. This waiver approval applies to the existing septic system to surface water and a septic system to a private well separations only. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. Should the operation of the subject wastewater disposal system cause any contamination or degradation of the subject surface water, this waiver will become void. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR950070 PID# 051-122-12 HA# Date Received: December 19, 1995 Legal Description: Lot 7 Block 1 Lake Hill Acres #5 Engineer: Ted Johnson, P.E., Criterium Alaska Engineers Permit PO Box 111790, Anchorage, Alaska 99511 Applicant: Richard Westlund Waiver Requested: Private well to drainfield of 86.6 feet; biocycle tank to surface water of '??-' 7~ z Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: o 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: Date: /-- / Q - ~ By: B~/~ ~O r~ Name of Reviewer Rec ~: 01543 3~rtount: $ 920.00 Date Paid: 12-19-95 4 2.23- 2,4 ;, ~r'. ~.... , rv'J -W DRILLING, Inc. P.O. Box 4-1728 · 2811 Dawson A C 907-279-1741 ANCHORJkGE, ALASKA 99509 .... '- - DRILLING LOG Well Owner -oeation (address of: Township, Range, Section, if Imown; or distance main road '-~i:·r:-.~' tak~, Eklu'tn~ ' Size o[ casing. ~ Depth of Hole X?.k ~'~ ~ o~ Statm ~vater level,--,~ := ft: :" (~) (below)_.. ................. land surface. F~ish of well (check one) open end ( ' .:X;5-~J}_.:.~" ' ' ~'': :~:. '~' %Veil pumping test at = gallons p~r (~) (minute) for I · hours with .... ~- . .... of drawdown from static level. '~, I;',[e of completion 7 June .7£ ':'77 i' ¢ . WELL LOG '. Depfi. ia feet from Giv~--a~taii~ '6f formations penetrated, size of material, color ground ~t~rface 0 TO ? - Sc. fifty ~revel ~i'th cccaisionr, l bbulders. ........ TO ..... TO 'TO TO .TO _TO TO .TO ;~-_; -~_---.... ,..~,~- ~? ,~ ?~;G~-,TER ANCHORAGE AREA BOROI' - -?. ::-';, ~-.~' - ~;-.. ~?.:;.:; ?~ (:;:-~')~: ~RTMENT 0F ENVIRONMENTAL INSPECTION REPOrt ON-:SITE SEWAGE DISPOSAL .SYSTEM _ .. . c.-- :_f!~- NAMe:. '-..~.. i'-' --,-:':.' ..'.-'.~;,.:~:ADDRES~ '... . ": . "::..-. - ~Fi~dNE -'" ': ~' ' -~:-z- -;?':-'7 ~ ~ :;;~:- :~:---~--;- :-~- ' ' ' -';. '~ ' ~ NUMBER OF : :-: 5~ L ' ':" 'T'? '~- -:':': -' ' .:~ '>%::~-.:::.(':; :,~:7~'~?,--C';' .:::~'::'?:":.~ ':: %.:3--~;. :' ::/'-"-. - ~:~': -:' ~: ,%-: : :': ~ QU D CAPACI~ ~ ~ GALLO~S::.].' INSIDE LENGTH' . :- INSIDE WIDTH '" ' DEPTH , N~s~-o~-P~ZS: - : ~- ': - -' 'o~ W~'D~. ' ', L~NOTH~ TILE:DRAIN FI DISTANCE FROM'W~ NUMBER~ OF ~TH OF J~AC TOTAL' LENGTH NEAREST LO~r LINE - ' ·IN, T DEPTH:- TOP OF TII 'OF FIETER MATERIAL BEN EATH' TIJ ~ ' -~ ": ';~ ~ ; ':qU'-'~'_`~` ;BUILDING FOUNDATION .?' SAMPLE'; LOf LINE'' ' - ' ' : "~'~ ?SEWER-uNE ~ ---:" -':~?:';-~ANE -'~{" '"';-j SYSTEM --I~: '~U,.CESSPOOL .... DISTANCES'.. MUNICIPALITY OF Development Services Department v, r On -Site Water & Wastewater Section Parcel I.D. 051-122-12 Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 7 ` 6 - Z 1. GENERAL INFORMATION Complete legal description Lake Hill Acres #5 Block 1 Lot 7 Location (site address) 22454 Hilltop Circle Current property owner(s) Westlund Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 250-4996 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $2-10 C'O V lP i Date of Payment 1111 '1,20ay Receipt Number O 1 q $ `i ts COSA # _OSG ZO I F, 31 Date: Waiver Fee $ _ Date of Payment Receipt Number Waiver # S. STATEMENT OF INSPECTIC}N 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. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site :eater 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 11/11/20 6. DSD SIGNATURE System #1 Approved for q bedrooms System 42 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: 4 �1�5r�E:G g WATER AND WAST%v''rATER %l0 �\ BI �"� Original Certificate Date: — (e_ -,— The Municipality of /'anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent protessiQnal civil engineer registered in the State cf Alaska. The falunicipality at Anchorage is not responsible for errorsor omissions in the professional cngincef's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Legal Description: Lake Hill Acres #5 Block 1 Lot 7 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/7/72 Total depth 302 ft Cased to 181 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 36+ in Date of flow test for COSA 10/15/20 Static water level at beginning of test 31 ft Comments B. TANK DATA Age of tank(s) 22 years Tank type/material Plastic Measured operating fluid level in septic tank na ❑ Standpipes/foundation cleanout per record drawing Date of pumping Regular Servicing D. ABSORPTION FIELD DATA 8/12/19 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 5 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 051-122-12 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 10/15/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station 22 years Lift station material Plastic Comments: BIOCyCIe Adequacy test date new Results F Pass For 4 bedrooms Fluid depth prior to test na in Water added na gal New depth na in Elapsed time na min Final fluid depth na in Absorption rate na gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private WL -11 on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' El Yes Yes Community Sewer Manhole/Cleanout > 1001 Yes if No ft V Yes 0 if No ft Neighboring Tank > 10V Yes if No ft Private SewerlSeptic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Yes if No 75 ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' ft Private Wells > 100' Animal Containment > 50' Ov Yes if No ft Yes if No ft if No ft Community Wells > 200' Yes if No ft Manure/Animal Excreta Storage > 100' F3 Community Sewer Main > 75' Yes if No ft � Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' El Yes Yes if No ft Surface Water > 100' Yes if No 50+ ft Property Line > 5' Wells on Adjacent Lots: Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Yes if No ft Water Service Line > 10' Absorption Field > 5' R1 Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' R, Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10? F3 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Ploas>e enter cli-stancos if less than required Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line -- 10' El Yes if No ft Wells on Adjacent Lots: Water Main > IQ' E Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Yes if No 50+ ft F. ENGINEER'S COMMENTS Property Line & Well Waiver on file OF '41L G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review A — of Municipal records that the above systems are in conformance with �4, V p # MOA COSA guidelines in effect on this date. ENst"ICk 0" 11/11/70 „i �C5)Anchorage AK 99503 =dvr,....3 Email: crbioak@gmail.com (907) 274-0314 Ist Quarter Inspection Report 2021 Homeowner Info Customer Name: Dick and Susan Westlund Address: 22454 Hilltop Circle Tank#: 12 Install Date: March 19�j Initial Inspection: Alarms Tested: Air 171 High Water 0 Battery Tested: Yes ❑ No ❑ N/A (Please make sure alarm is on "normal", not "mute") Does system have a septic tank ? No 171 Yes ❑ (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes Repaired ❑ Yes 171 Repaired ❑ Strong[:] Mild ❑ None System Inspection Inlet plumbing in working order? Solids pillow normal? Yes 171 Replaced El Yes R1 Requires Pumping El Are all aerators functioning? Yes ❑ Replaced ❑ Clarification return system operating? Yes 0 Adjusted pH Reading: (pH of 6-8 is ideal) 7.3 Pump float operating? Yes 0 Replaced ❑ Filter cleaned? Yes FY71 N/A Dissolved Oxygen PPM (2-5 is ideal) 3.5 Alarm float functioning? Yes � Replaced ❑ Any buildup of solids? Yes❑ No F,4 Any buildup of solids? Yes ❑ N o Turbidity of discharge (in FTU) (Under 35 FTU is considered compliant.) 9.23 Any buildup of solids? Yes ❑ No Discharge line condition: Good [Z Replaced Comments: Has emailing or mailing of form been requested? Yes ❑ No ❑ Inspected By: Chris Date: 03/06/2021 (contact office to request...) MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of Mwfi .A of 20x1 , by and between herein the "OWNER,- and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and/ operate an Advanced Wastewater Treatment System (AWWTS), described as k ' G Lj calk - located at (legal description) 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in �} accordance with the equipment's approval for operation in the Municipality. J ll It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). S� Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. 5-8 Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 5 `3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. S -L Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without anew Certificate of On -Site Systems Approval. 2_ Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. S� Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by ,authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Lay. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial. District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: (signature) Date: 6AAe-e i ZU Z� LJ Gf/�1 vl 2&_V1 / (print name) STATE OF ALASKA. ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this _ day of Mlj , 20 V I , by \�� CGA. h'(/ NOTARY PUBLIC FOR ALASKA My Commission expires: rtb. lS , moo l MUNICIPALITY: -B �: (signature) (print name) NOTARY '., PUBLIC ..-** Date: — Z,2— Title: (rev. 05/18/2018) Page 3 of 3 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 GENERAL INFORMATION Complete legal description Location (site address or directidns) Property'owner I()f')O ',, .._1¢{C./~ · ~J3/~_~2.. Day phone Mailing address ~ ~' ~/~/ ,~, L~/'~ ~/ Lending agency..~/O~/~/~'~'~:-' ~0C~¢ (~dh) Day pho;e Unless othe~ise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ' ~ TYPE OF WATER SUPPLY: . Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site · ' Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further 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 ~'-'~C~,~J~'~(q,~L~'i ~ ~:)~)~/n(,~[,.~ Phone. ~'"~'~(_P' ~ Address DHHS SIGNATURE /~' Approved for ~- Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an.independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending insfitutions in order to satisff/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% work. 72-025 (Rev. 1/91) 8~k MOA ~21 (~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: LOJ¢ ~ I~JoclL / LCL~_J-~'lJ¢'arce,,.D. A. WELL DATA Well type ~~ If A, B, or C, attach ADEC letter. ADEC water system number Log Present (y/N) ~,/¢¢~> Totaldepth 3P~/'~ Sanitary seal (Y/N) \/¢' ~b Date completed (-.¢/'~/"~ Driller cased to Casing height Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION RECEIVED SEP 8 199 ~:,~i'.~.;: F~i,iy Ot Anchorage Oept. Health & Human Services SEPARATION DISTANCES FROM WELL TO: j,~z~ Septic/holding tank on lot ~ Public sewer main ~! Sewer service line ; On adjacent lots iF)L) ; On adjacent lots Public sewer manhole/cleanout Petroleum tank I00' ¢- 100' -k WATER SAMPLE RESULTS: Coliform ~_h ~('~ (~) r Date of sample: ~/~/q~-,~ Nitrate ~.~-~-~' ~c.~ Other bacteria Collected by: '~~'L/~ D B. SEPTIC/HOLDING TANK DATA Date installed /~ Tank size '"'/~) Compartments Cleanouts'(Y/N) \J~-~. Foundation cleanout (Y/N) \ ]~.z~, Depression(Y/N) High water alarm (Y/N) ~'//~) Alarm tested (Y/N) Date of pumping [-~/~)'~/q~ Pumper SEPARATION DISTANOESF~OM SEPTIC/HOLDING TANK TO: Well(s) on lot :0 )':~ On adjacent lots To property line I,O/ J~ Absorption field {(~ /~'- watermain/serviceline I~/ J- Surface water/drainage' lDO / 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed Length q:/~ Width Total absorption area . ,~-~"'~ Depression over field (Y/Nh Results (pass/fail) V~[ ~.~ Peroxide treatment (past 12 months) (Y/N) Surface water Soil rating. Total depth ,-~'/' . bedrooms Gravel thickness. Cleanouts [?resent (Y/N) Date of adequacy test for If yes, give date SEPARATION DISTANCE FJ~_ABSORPTION FIELD TO: Well on Iot_.~-- ~~ On adjacent lots To building foundation '~ /~/ h To existing or abandoned system on lot. On adjacent lots Surface water Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effecton the date of this inspection. ,'.~. ~,~ ~:: .... ,,% ~ Engineer's Name Date HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-020 (Rev. 3191) Bar;k MOA 21  ; Municipality of Anchorage  Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHEC:(LIST Legal Description: /~)¢- d ~/~',>_ J ,~4~¢¢ /?~/'//~Parcel I.D. ~ ~'~/ A. WELL DATA Well type P('i' I/0.1~¢~ If A, B, or C, attach ADEC letter. ADE~w~,at'.'e?~'~.t~'4~.umber Log present (Y/N) ¢~__/Z~' Date completed ~ller Total depth ~. ~)~' % ~'"~ased to ~ Casing height Sanitary seal (Y/N) ~ ~erly protected (Y/N) Date of test '~' ~ ~'~'~'~ ~"~- ~ ~ ~"'-'(~'--'~ Static water level ~ ~ Well flow 2 g.p.m, d; ~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ ; On adjacent lots Absorption field on lot ~ '~ /00~ ; On adjacent lots Public sewer main J 00/~ Public sewer manhole/cleanout Sewer se~ice line I ~0~ '~ Petroleum tank I00 ' +' WATER SAMPLE RESULTS: Coliform ..~?L/~ :l~..(~:¢~) ~---(/ Nitrate Date of sample: : ~.~'.~ ~ (~?L~/r(j Other bacteria Collected by:/"~O~C ~ B. SEPTIC/HOLDING TANK DATA Cleanouts (Y/~): :?: V¢_.¢,-~') Euondation cleanout (Y/N) High water ~l~rrn (Y/N) ..:/")~ Alarm tested (Y/N) Date of pumping & '~ '~ Pumper SEPARATK~N D STA;NCEs FROM sEpTIc/HOLDING TANK TO: Well(s) on lot ~ / ~ ' On'adjacent lots To property line /L~ "P ' Absorption field Surface water/drainage- /(~) I '~ Compartments Depression (Y/N) Foundation r~(~,p fOE) Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE Size ~ gallons Vent (¥/NI High water alarm level "Pumo on" level at Manufacturer Mannole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D, ABSORPTION FIELD DATA Date installed /Q/~ Soil rating ~_/~/~,/OO ~]/0 System type Length /~.~.~i/'~t)'/¢'~ Width I,)~LI'~/)!,(.}¢ Gravelthickness (,],O]~/)/X,)/~ Totaldepth/)/O~/"?/)/xJ/'/ Total absorption' area :'~ Cleanouts present (Y/N) Depression over field (Y/N) /'-)O Date of adequacy test Results (pass/fail) P~ ,~_~ for ~"~ bedrooms Peroxide treatment (past 12 months) (Y/N) ~)O If yes, give date ,_¢~-PARATION DI OM ABSORPTION FIELD TO: 'r: CZ . . / Well on lot (r '~q~ '-'~/2/~ On adjacent lots //r~z) ~. Property line ' ' d~'o~/ /(~/:¢ TO existing or abandoned system To bullduqg foun on lot On adjacent lots /00/ I- Cutbank ,~(_/, /- Water main/service line Surface water (¢~ /h Driveway, parking/vehicle storage area Curtain drain 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 inspection. Signature / ' ' Waiver Fee: $ ./ HAA Fee $ Date of Payment Receipt Number 72-O26 fRev, 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR930057 PID# 051-122-12 HA# HA930371 Permit Date Received: September 8, 1993 Legal Description: Lot 7 Block 1 Lake Hills Acres #5 Engineer: Howard C. Holtan, P.E. PO Box 243193, Anchorage, Alaska 99524 Applicant: Tom & Jack Bolke Waiver Requested:~au~Y lleid to s~r~ace w~t~z - $5 fee~~xw~xx xk~x~pki~x~kx~w~; private well to leachfield of 90 feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient o E. Horizontal Separation TOTAL: Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: ~/~ ~//~-~ Date: ~eviewer Rec ~: 25118/9950 Amount: $ 920.00 Date Paid: 9-8-93 Howard C. Holtan, P.E. P.O. Box 243'193 Anchorage, Alaska 99524 MUNICIPALrI'Y OF ANCHORAGE ENVIRONMENTAl. SERVICES DIVISlO~ SEP 0 8 199~ RECEIVED August 31, 1993 Municipality of Anchorage Department of Health & Human Services Environmental Health - On-Site Services 825 L Street, #502 Anchorage, Alaska 99501 Ref: Surface Water-to-Absorption Trench Separation Distance Waiver Request Lot 7, Block 1, Lake Hills Acres Subdivision #5 Gentlemen: This letter is to request a waiver of the surface water-to-absorption trench distance for the referenced property pursuant to the provisions of AMC 15.65.140. During performance of adequacy testing of the on-site water and wastewater systems on the referenced property, it was determined the existing absorption trench did not meet the minimum separation requirement from the ordinary high water of Mirror Lake of 100 feet as required by Alaska Administrative Code 18 AAC 72. The system was installed as per a Greater Anchorage Area Borough Permit issued in August 1972. A copy of the inspection report is attached. A field inspection conducted June 25, 1993, determined a separation of approximately 85 feet, measured horizontally, for the absorption field. The separation distance measurement over the ground surface was approximately 103 feet (slope distance). This difference results from the considerable relief between the absorption trench and the surface of Mirror Lake. Please see the attached topo map. I recommend the separation waiver request be granted for the following reasons: The slope distance measurement of 103 feet, which meets the separation requirement, is the appropriate measurement to use. The shortest effluent flow path from the absorption field to the lake is this distance. The primary purpose of the separation requirement is to provide reasonable assurance of enough soil for treatment of effluent to remove pathogens. In this case, the requirement is met. Municipality of Anchorage On-Site Services August 31, 1993 Page 2 There is no evidence that absorption field effluent is now or has in the past surfaced between the absorption field and the lake. One can therefore conclude that the effluent takes the subsurface path to the lake if, in fact, it is flowing in that direction, and is therefore subject treatment. Please call if you have any questions or you require additional information. Howard C. Holtan, P.E. CE-3063 attachment: Howard C. Holtan, P.E. P.O. Box 243193 Anchorage, Alaska 99524 August 20, 1993 Municipality of Anchorage Department of Health & Human Services Environmental Health - On-Site Services 825 L Street, #502 Anchorage, Alaska 99501 RECEIVED Dept./-/e~/~'~?,~t Anchor~,~^ ~'~ ~un 'Services Attn: Mr. Dan Roth, P.E. Ref: Well-to-Wastewater System Separation Distance Waiver Request Lot 7. , Block 1, Lake Hills Acres Subdivision #5 Dear Mr. Roth: This letter is to request a waiver of the well-to-wastewater system distance for the referenced property pursuant to the provisions of AMC 15.65.140. During performance of adequacy testing of the on-site water and wastewater systems on the referenced property, it was determined the existing septic tank and absorption field did not meet the minimum separation requirement from the private well of 100 feet as required by Alaska Administrative Code 18 AAC 72. The systems were installed as per a Greater Anchorage Area Borough Permit issued in August 1972. A copy of the inspection report is attached. A field inspection conducted June 25, 1993, determined a separation of approximately 80 feet for the septic tank and 90 feet for the nearest part of the absorption field. The septic tank separation is acceptable as it is "grandfathered" under the then current minimum separation requirement of 50 feet. A recent survey asbuilt of the referenced property is also attached for your use. The following information and analyses is offered for your consideration in evaluation of the waiver request: 1. Geolo,qical: a) The topography of the referenced property slopes at approximately 8% from the vicinity of the well to the area of the wastewater system. However, based on the attached area topo map which shows contours on undeveloped land surrounding the disturbed areas of the property, it appears that the natural pre-construction slope may have been 15-20% between the locations of the well and the wastewater system. The well log attached indicates bedrock of unknown fracture is approximately 8 feet below ground surface. The bedrock is not exposed in the vicinity of the Mr. Dan Roth, P.E. August 20, 1993 Page 2 wastewater system and therefore the rock surface must decline in the direction of the wastewater system. The suggested preconstruction contours and the construction of the wastewater system above the bedrock imply this decline may even be the 20-25% of the preconstruction ground surface. b) Other geological conditions: Distance from the sewa,qe system bottom to water table - the distance is not documented. However, based on the well log, lack of surface water indications and the wastewater system construction, it is believed the water table is not less than four feet below the bottom of the sewage system. Soil sorption below the sewaqe system - based on the well log, the soil sorption system is likely a sandy gravel with fairly high permeability. This material appears to extend down to the surface of bedrock. Soil permeability below the system - as described before the soil below the system is likely a sandy gravel down to bedrock Water table ,qradient - Water table gradient information is not available for the property. However, given the relative steep ground and bedrock slope from the well to the wastewater system, the lack of surface appearance of water downslope of the well and wastewater systems, and the general area topography as shown on the attached topo map, it is likely the shallow water gradient is at least 15-20% from the well to the wastewater system. Further, Mirror Lake is adjacent to the property and downslope approximately 50 feet in elevation from the wastewater system. In addition, available nearby wells logs and soil test holes, copies attached for your review, suggest a water table substantially lower than at the well on the referenced property. However, under conditions of maximum drawdown of the well as determined during test pumping on June 25, 1993, the gradient would be in excess of 60% from the wastewater system to the maximum drawdown elevation. This could be significant, if the bedrock is significantly fractured and there is a water flow path between the systems. However, the well was drilled over two hundred feet to a fracture zone to supply adequate water, indicating the overlaying rock is fairly tight. Horizontal separation - as indicated previously the, well is separated from the septic tank by approximately 80 feet and from the absorption field by approximately 90 feet. Mr. Dan Roth, P.E. August 20, 1993 Page 3 2. Special Construction: a) The well was cased to 18 feet, approximately 8 feet below the bedrock surface. This construction greatly reduces the possibility of contamination from effluent above the bedrock surface. b) The well was installed upslope of the wastewater system to take advantage of the ground slope and likely subsurface water gradient. 3. Other: a) The waiver request for the leach field is approximately 10% of the required separation distance. b) The three bedroom residence is sited on an approximately 28,000 square-foot lot resulting in a density of approximately 9,300 square foot per bedroom. Other developed lots in the area have similar densities. c) There is no special lot shape or structural barrier considerations to assist in mitigation of the substandard separation distances. d) The population at risk is relatively small and consists of the family in residence on the property. e) A water sample from the well on June 25, 1993, tested negative for coliform bacteria and nitrogen compounds. A copy is attached for your review. There is no record of any previous water quality problems with the well. I recommend approval of the requested waiver because there is no evidence of contamination of the well in the 20 plus years the wastewater system and well have been in use on the referenced property. This suggests that there is not a connection, or flow path of contamination from the wastewater system to the well. Further, the water gradient may well be away from the well toward the wastewater system and/or, the bedrock is tight between the well acquifer source and the wastewater system. Please call if you have any questions or you require additional information. S,n CE-3063 attachment: I ;n - 2 -4'-1 ISO .r. its, ki�; pf I hereby certify pAt. ;Akia'-f the mowlw described prope x rty!.J&;�M -_ Anchorage.-ReC*r di, imp�saaexrtlilies Itts 1$ N' 0 FIJ." pro n . Aidjacent th b. , art'as`lY�Dft 21Uest ch 40 th, nes or othlrr 4 m indfautou b4 Dated a, Eagle lkivft, AlaskA Et ........... MUNICIPALITY OF ANCHORAGE DEPT.  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI0.N~VIRON .,~NT/\L ; :CTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION ["~/\Y Telephone 264-4720 RECEIVE[) REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER ~ PHONE PROPERTY RESIDENT (If different from a~o~ PHONE 2. BUYER PHONE 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4, REALTOR/AGEN~ ' / J PHONE MA~ L~ 6G A~S~ ' STREEt.T/LO~ATi~N' ~' ] 6. TYPE OF RESIDENCE t~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four ~ Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY If md~v~dual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS I~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER E~]Septic Tank or []HoLding Tank Size: If Tank ks homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS ~A'~ ROVE D FOR _~__~EDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) DATE BY (Ti t]~)-----~. LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1.,~ROPERTY O~NER I PHONE M~LING AD, DRES~ '" ~ PROPERTY RESIDENT (If different from able) ' ' PHONE 2. BUYER PHONE MAILING ADDRESS 3',' ~ENDING INSTITUTION J PHONE I MAI LING ADDRESS 4. REA LTO R/AG ENT ,~ 5. LEGAL DESCRIPTION STR E ET L©CATI ON 6. TYPE OF RESIDENCE ~/~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four E;~ Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY ' INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE*~ [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) **If individual/on-site, give installation date ~ If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS FIME TIME TIME DATE DATE DATE -~SPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYP.~ OF RESIDENCE NUMBER OF BEDROOMS L~I SINGLE FAMILY E~.,/ON E [] THREE E~] F~VE [] OTHER [] MULTIPLE FAMILY VLyJ TWO [] FOUR [] SIX PERMIT NUMBER 2. ~R SUPPLY LtZJ INDIVIDUAL DEPTH OF WELL [] COMMUNITY [] PUBLIC UTILITY DATE DRILLE:D Connection Verified LOG RECEIVED 3,-S/~AGE DISPOSAL SYSTEM PERMIT NUMBER L~ INDIVIDUAL/ON -SITE DATE INSTALLED E~] PUBLIC UTILITY _[~seO,..~Rect ion Verified INSTALLER ptic .T_~]k or ~Holding Tank Size: 7.~~) If Tank is homemade SOILS RATING give dimensions: T O'FA L A B S 0 R/~.I ~A~j~. ''' i-- ' Sewer Line ~Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [] CONDITIONAL APPBOVAL (letter must accompany certificate} [] DISAPPROVED BY (Title) DATE LEGAL DESCRIPTION - _ 72-010 (Rev. 3/78) ,.... MUNICIPALITY OF ANCHORAGF., ~C~ ~_LL~en DEPARTM - OF HEALTH AND ENV!RONMEh' L PROTECTION 825 L Street, Anchoraa~. Alaska 99501 264-4720 Date Received: December 30, 1977 ~1: Time d~i~[) dn~ ~2: Time #3: Time Date /-1~7~ .~/%LLI~. Date Date Insp ~N.~/. Insp Insp 4: o REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: First Federal Savings & Loan Association Mailing Address: Post Office Box 1910 wasilla 996~one: 376-5201 Property Owner: Edward D./Phyllis J. Erp Phone: Mailing Address: Post Office Box 58 Chugiak, 99567 688-2376 Legal Description: Lot 7 ~~Lake Hill Acres Subdivision #5 Single Family Residence: (x) Multiple Family Residence: ( Well System: Permit # Construction Number of Bedrooms: Two Number of Bedrooms: Individual well (x) Community/Public System ( ) Depth of Well 300' Well Log on File Bacterial Analysis e Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System (x) Installed 1972 7:3-0 Soils Rate Distances: Well to Septic Tank to Sewer Line Nearest Lot line to Nearest Lot Line Public Utility ( ) Installer Manufacturer Material to Absorpti Area Absorption Area ~e'T~o Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 7 Block 1 Lake Hill Acres Subdivisian #5 Comments: Affadavit Attached: ([ Letter Attached: ( ) Approved: ~ Date: Disapproved: /~.~ ~g ~/)' Date: Department Worksheet: ~,~-o9~, ;,o ~: o~ ,~ 11~1~ 'WNOIIYNIJ]INI ~0:1 ION (~p!, ~m ~S) --O]OIAOBd tgVN3^O~ 30N~flSNI ON I£6I '~¥ 008£ ~Jo~ $~ .................................... (peJ!nbo~ es½ o~xe) ABgAI]30 q¥193dS ~OS ...................................................... A~NO 33SS3~G0¥ Ol ~3AI]30 ~g~- ............ XJuo aassaJppe ol X aA.tap ql!M j~ $]91AB~$ ~S ........... pa~a^!IaP elep puc moq~ ol s~oq$ 'J H~flL3B ]aoo dlZ~QNg 3~¥~ "O'd 'ON aNY 011N]$ (a~elsod snld) J08~'i1¥~ a31:ILLB~O UO~ .L~II]OD~I TAT~O ./ VICINITY MAP SCALE i,'= MiLE TRACT B goo CERTIFICATE OF OWNERSHIP AND DEDICATION NOTARY'S ACKNOWLEDGMENT SUBSCRIBED AND SWORN BEFORE ME THIS J~/v , SPECIFICATIONS ON UTIL)TY EASEMENTS PLAT APPROVAL PLAT APPROVED BY THE B~OUC~OU PLANNING COMMISSION ~Tl~OhlZEO OFFICIAL DT1000896 ,//'/,kc. zPoo,4' /"/j' NOTES: FIFTH ADDITION LAKE HILL ACRES SUBDIVISION LOCATED IN