HomeMy WebLinkAboutLAKE HILL ACRES #6 BLK B LT 1-ALake Hill Acres
#6
Block B
Lot I - A
#051-122-75
PER CONTRACTOR, THE OLD TANK WAS DECOMMISSIONED PER UPC Pump Make & Mode • cGi<ol Inspections performed by:
PIPE MATERIAL
House to tank D3034 Tank to _
Installer
drainfield
JR'S PUMPING Drainfield - CO/MT -
Inspector GEG, Ltd. BENCH MARK (Assumed elevation)
Inspection 100.00 Ft.
Dates: 1st 8/30/13 2nd — Lmaton and Descrfption:
3rd — 4th — TOP OF DECK @ FRONT DOOR
EER'8
Community Development Department Approval ENGIN
_ENGIN
Conditional approval: Date:
SUbMi W a
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water & Wastewater Program
4700 Elmore St. • P.O. Box 196650
Anchorage, AK 99519-6650 a http://www.muni.org/onsite - (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP131212
PID Number: 051-122-43 ❑ New ®Upgrade
Name:
GREG WILKINS
ABSORPTION FIELD
El Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address:�2 O
.2.29.29 ANT EM PLACE *EAGLE
RIVER, AK 99577
❑ Other
Phone:
No. of Bedrooms:
Soil Rating:
Total Depth from original gmde:
242-1638
3
GPD/Sq. Ft
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade:
Ft
G. .1 depth beneath e:
Ft.
Subdivision:
LAKE HILL ACRES #6
Block: Lot).
B
Fill atltled above original grade:
G. rgth:
ownship: — tinge: —
ec ion: —
Gravel width:
Ft'
Fr.
Beds Number of linea Distance between lines:
Ft.
SEPARATION DISTANCES
Total absamti area:
umber of trenches:
Dist. between trenches:
To
Septic
Public/Private
From Tankank
Sewer Lines
SD. Ft.
Ft.
Well
75'+—
25'+
TANK ❑ Se tic ❑ S.T.E.P. ®Holdin ❑Other
Manufacturer:
capacity:
Surface water
700'+—
7Ablding
ANCHORAGE TANK
4000cal.
Lot Line
rj'+—
N/A
Material:
Number of compartments:
STEELFoundation
5'+_LIFT
STATION
Curtain Drain
Manufacturer. Capacity:
PER CONTRACTOR, THE OLD TANK WAS DECOMMISSIONED PER UPC Pump Make & Mode • cGi<ol Inspections performed by:
PIPE MATERIAL
House to tank D3034 Tank to _
Installer
drainfield
JR'S PUMPING Drainfield - CO/MT -
Inspector GEG, Ltd. BENCH MARK (Assumed elevation)
Inspection 100.00 Ft.
Dates: 1st 8/30/13 2nd — Lmaton and Descrfption:
3rd — 4th — TOP OF DECK @ FRONT DOOR
EER'8
Community Development Department Approval ENGIN
_ENGIN
Conditional approval: Date:
PERMIT NUMBER: AS -BUILT DRAWING PARCEL INUMBER:
-
OSP131212 051-11 22-43
LAKE HILL ACRES #6;
BLOCK A, LOT 10
SEPTIC
I, AREA
I
I
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I
I
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I
LAKE HILL ACRES #6;
A B BLOCK B, LOTr If
32.35
DELIE73.97
DBL2
33.08
-ST 1_
66.80
ST2
74.39
ST3
82.06
1
1
I
I
I
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I I
I �
I 5
I \
I STANDING WATER
OBSERVED ON I 4' X 4" INSULAT101
7/10/13 UNDER DRIVEWAY
�j Peo> ��rar2.
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S®
1"=40'
00' SETBACK -
3 BEDROOM
HOUSE
GARNESS ENGINEERING GROUP, Ltd.
- CONSULTANTS & GENERAL CONTRACTORS
3"1 E. NOOK P090. WM 101 • "HOPAOE, M 99601 • PHOlB: (907)33)-81)8 • FM (907)339-35 8 • ME960F c gamwen9Ma11px9m
'PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
GREG WILKINS 242-1638 2 OF 3
LEGAL DESCRIPTION: DRAWN BY:
LAKE HILL ACRES # BLOCK B, LOT oq_ PNB
TYPE OF WORK: DATE:
AS -BUILT DRAWING 9/13/13
\ UI
N l
rl• `.y Z \
\ I
U
LOT UNE FLAGGED' /
BY SURVEYOR PRIOR �.
TO CONSTRUCTION
GALLON '
TANK. I
pir I SO
wo PJA
/1
PERMIT NUMBER: AS—BUILT DRAWING � ING PARCEL INUMBER:
—
OSP131212 051-11 22-43
TOP OF TANK AT
INLET = 94.36
INVERT OF BUNG -
AT INLET = 93.70
FINAL GRADE _
95;-72-98.71
94'5
STi ALARM ST2
,q (� TOP OF TANK AT
I I r OUTLET = 94.48
NEW 4000 GALLON
HOLDING TANK
GARNESS ENGINEERING GROUP, Ltd. _* 4 H
CONSULTANTS & GENERAL CONTRACTORS ...... .. .. . ..... ..........
3"1 E. Moors rs , surto ,ai • MCHORWe, W OW • PHONE (90))33)-6M • FAX (907)339-3218 • MF89pE: mn.9omwmgvmvin9som
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • • . . • • • • . . . . . . . . ... • ..
GREG WILKINS 242-1638 3 OF 3 On p. Y ess.-
LEGAL DESCRIPTION: DRAWN BY: 1/OsOy. CE -795 iG
LAKE HILL ACRES #6; BLOCK B, LOT PNB DOfe �JZ�� o°dG
TYPE OF WORK: DATE: QQOd pEo fessio�o��o
PROFILE AS—BUILT DRAWING 9/13/13
On -Site Wastewater Disposal System Permit
Permit Number: OSP131212
Tax Code Number: 05112243000
Work Type: Septic
Permit Effective Dates: July 30, 2013
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
to July 30, 2014
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: LAKE HILL ACRES #6
Site Legal Address: LAKE HILL ACRES 46 BLK BLT 2 G:1562
Owner/Address: JOHNSTON MELVIN E & LINDA M
PO BOX 2250 JASPER OR 974380000
Site Mailing Address: 22220 ANTHEM PL, Chugiak
This permit is for the construction of:
N Disposal Field N Septic Tank Y Holding Tank
3- 30-13
Lot Size in Sq Ft: 37815
Total Bedrooms: 3
N Privy N Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
J v
Issued By:
Date:
Date:
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 051—ia;)_g3
Phone: 907-343-7904
Fax: 907- 343-7997
Property owner(s) GREG WILKINS Day phone 242-1638
Mailing address EM PLACE *EAGLE RIVER, AK 99577
Site address
Legal description (Sub'd, Block & Lot) LAKE 1 -
Legal
Legal description (Township, Section & Range)
Lot Size
Sq. Ft. Number of Bedrooms
3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
(Fall that apply)
Initial ❑
Single Family (SF)
Absorption Field
❑
Upgrade E
(w/wo ADU)
Septic Tank
❑Renewal
❑
Duplex (D)
❑
Holding Tank
®
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
N/A Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number: a lib�-G
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORSaw
July 30, 2013
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Rd.
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Attn: Deb Wockenfuss
Ref: Proposed Holding Tank Upgrade for Lake Hill Acres #6; Block 1, Lot 2
Ms. Wockenfuss:
The owner of Lots 1 & 2 (Bk B) is currently trying to re -plat the two lots into a single parcel. We
attempted to identify a suitable site to place a septic system on Lot 1, but were unsuccessful. The area
throughout the general vicinity appears to be wetlands with isolated areas of imported fill. The ability of
Lot 2 to support an onsite septic system is doubtful. Given the marginal conditions, it is my opinion that
a holding tank is the most certain solution to meet the onsite wastewater disposal needs for the existing
residence.
If you have any questions, please contact us at 337-6179. Thank you for your assistance
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
100 k'fLL RADI
E HILL ACRES LAKE HILL ACRE LAKE HILL ACRES 'KE 'HILL ACRES LAKES\ HILL ACRE I LAKES HILL ACRES
#3; LOT 20 #3; \tOT 21 #3; LOT 22 LOT 23 #5+. LOT 1LOT 2
\\ \ \X \
]1Y.
— - - - I LAKE HILL ACRES #6; ,
I BLOCK C. LOT 1
TESTHOLE LOCATION
IS APPROXIMATE
TH#1
/ LAIi HILL ACRES #6;
8LCCK A. LO� 10 LAKE HILL ACRES #6/-
/ / \ I�R�EAIC BLOCK 8,/LOTj/
P 00. 1 I �
/
/10 W RI / 0STANDING
WATER
BSERVED ON
/ ARES 7/10/13
/ LAKE HILL ACRES #6; LAKE HILLACkES #6; 1
/ BLOCK A, LOT 9 1 I--BL6CIi C, LOT 2 1
I� I--100' I I �RIC
\ I I � 11
LAKE HILL ACRES#6; I 1{
BLOCK B. LOT 3 I
A `
I \
�PO i I LAKE HILL ACRES #6; \
BLOCK C, LOT 3 \
SCALE: I \
1°= 100' \
00006popp�4
0... A.�gs�o4
GARNESS ENGINEERING GROUP, Ltd. * : H
CONSULTANTS & GENERAL CONTRACTORS _ ....:. ... .... .............. D
1 E. NWR ROP➢, SUITE 101 ° PNCHOIUOE, AI( 99507 °PHONE (907)317-8179 ° FAX (90))3]8 3216 ° WEBSITE R,IW 9amawNl1 dn9.aam
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• ••• •.•••• D
GREG WILKINS 242-1638 1 OF 2 Q frey 0'r ss;'
LEGAL DESCRIPTION: DRAWN BY: OAPs@., CEr 79;
LAKE HILL ACRES ft, BLOCK B, LOT 2 PNB VOQf / (.7412..- n`o
TYPE OF WORK: DATE: 4QOOOp��000,\
SITE PLAN 6/5/13
NOTE:,THE CONTRACTOR
,SHALL HAVE THE EAST
LOT LINE, 100' SURFACE
WATER SETBACK, AND ALL
WELL RADII FLAGGED BY A
REGISTERED LAND
SURVEYOR PRIOR TO
CONSTRUCTION.
LAKE HILL ACRES #6;
BLOCK A, LOT 10
\
11 PTI C
1
AREA
I
I
I
1
STANDING WATER
OBSERVED ON
7/10/13
LAKEHILLACRES #6
BLOCK B, LOT 2
I
Ir
II I
I I
I I
I 11
I 11 \
I \ \
I �
'X
4" INSUDITI
�I
UNDER DRIVEWA
I \
I \ \
EXISTING HOLDIN \
TANK TO BE\
bECOMMISSIONEI PER
UPC.
I
�100' SETBACK—
v
UNSUITABLE SOILS
/ I
/ � X
Ln_ I \
3 BEDROOM
HOUSE
GARNESS ENGINEERING GROUP, Ltd
CONSULTANTS & GENERAL CONTRACTORS
I E. 1 WR R . SNTE 101 • MOOVJO , M 99507 • P NE (807)337-6119 • FM (07)336-3M • WEBSITE: x wx a„wam91nea Mp m
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
GREG WILKINS 1 242-1638 1 2 OF 2
LEGAL DESCRIPTION:
LAKE HILL ACRES
; BLOCK B, LOT 2
OF WORK:
INITIAL HOLDING TANK DESIGN
PNB
7/1/13
,X
PROPOSED 4000 I
.......�.l3 ysu��
�i
4 .r
e A. e
;ss.-
C 79 pf® la�••' ��oo
GARNESS ENGINEERING L GROUP, Ltd. 4
_ . CONSULTANTS B GENERACONTTRACTORS .. _ _ ... {F
MI E MU RW, SURE 101 • MCHM14L M. 88607 • Pl E- 807)337-61]9 • FM-. (W)338-320 • WEBSRC 9amww^81rro•rliq.cwn
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION' LAKE HILL ACRES S/D; BLOCK B, LOT 1 • J fa
PERFORMED
FOR:
GREG WILKINS DATE
ORGANICS
TEST HOLE #1
DEPTH
(feet)
6/13/13
6"
—
2
4:41 30
5 13/16"
3/16"
N
GW/FILL SOIL CLASSIFICATIONS
1
I
TESTHOLE LOCATION
GW ORG
3
IS APPROXIMATE
GP ML
GM TO ML GM CL
4
GC OL
1
SW MH
5
,,,---,
'��'• SP CH
IJ �-
GW ® 5.5' SM i OH
6
SC
7 GM
a-
9
10 B.OH.
11
12-
13-
14-
15-
16-
17-
18—
DEPTH
2131415161718
DEPTH TO
GROUNDWATER
DATE
WEEP ® 7'
6/12/13
5.5'
6/13/13
6"
—
2
4:41 30
�ys,upo
T .•� �I
A. G rness:
8I—i— 5;3' 53 v�
j�cFaG
DATE READING
CLOCK NET TIME
TIME (MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/13/2013 1
4:11 —
6"
—
2
4:41 30
5 13/16"
3/16"
N
4:41 —
1
I
TESTHOLE LOCATION
4
/ 1
IS APPROXIMATE
1/8"
1I
-r' I
1
I
,,,---,
IJ �-
1 II
'
I
I
!
\
scA :I
1
I
1 � 0'
DATE READING
CLOCK NET TIME
TIME (MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/13/2013 1
4:11 —
6"
—
2
4:41 30
5 13/16"
3/16"
3
4:41 —
6"
—
4
5:11 30
5 7/8"
1/8"
19� PERCOLATION RATE >120 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 2.5 FT. AND 3.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: & 114 li2
0 0
GREATER ANCHORAGE AREA BOROUGH
e uw�w"
NAME OF APPLICANT.
INSTALLATION LOCATI
LEGAL DESCRIPTION -
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330"C"STREET ANCHORAGE, ALASKA 99503
C(s%PHONE 274-4561
r
- APPLICATION AND PERMIT
MAILING ADDRESS
PERMIT NO.
®'
lc
SEEPAGE PIT , DRAIN FIELD OTHER —
TO BE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK U /
SEEPAGE AREA SIZE
FOUNDATION TO SEEPAGE PIT led f,� , DRAW FIELD
SEPTIC TANK TO SE////
EPAGGE PIT WALL ��/
����jj
SEPTIC TANK �, SEEPAGE PIT , DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK �L( SEEPAGE PIT
DRAIN FIELDALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC �TTA((NK ---le/� , SEEPAGE PIT
DRAIN FIELD 406
SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION..
6.A.A.B.Q
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. If.
DATE _�✓ APPLICANT'S SIGNATURE
FORM NO. EG -016
flTby
�e�
A & L DRILLING COMPAN19t7 % Ae
BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694.259BF Cr�ij;��.-nr
�o
OWNER OF LAND J Q HFw so A) DEPTH OF WELL
ADDRESS Pb Aox SSd STATIC LEVEL OF'WATER FT. S
LEGAL DESCRIPTION L o r 1 &le A 4J9rs Nac 6CP- S PkDRAW DOWN FT. 3S
DATE - Started 7 Ended -7 GALS. PER HR -7000
PERMIT NUMBER ;j%'� n KIND OACASIN� C$ 0 0
r K) n nnn�.n� �n/ 11 • rJ V (( 14
KIND OF FORMATION:
From 0 Ft. to—.Z—Ft. DyE/1 �3u�P06�
From Ft. to__/.tLFt. /� P
FromFt. tom _Ft.(Li9i' 4,iU ,rl <tJEl
From _Ft. to_L.5____Ft. ,�47UPt9i£D 77 /F
From Ft. to -7 -?—Ft. Fi s .54.vo wE 77
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DRILLER'S NAME '"'"�
1
August 3, 1977
#76587
Robert Chopp
Box 873
Eagle River, Alaska 99577
Subjects Permit Expiration
Dear Mr. Chopp:
a
A permit issued by this department for well and/or on-site
sewer installation on Lot 1 Block B Lake Hill Acres #6
has expired since the issue date exceeds one (1) year.
In the event you still plan to install the well and/or on-
site sewer system, a new permit is required. The original
soil test may be used to obtain a current permit.
If the well has been drilled, a well log should be sent
to this department to document the installation date.
If you have any questions regarding the above matter, please
do not hesitate to contact this office immediately at, 279-
2511# extension 224 or 225.
Sincerely,
Les N. Buchholz, R.B.
Sanitarian
LNB.ljh
DEPHRTMENT O HLTH HMD ENYlRONMENTGL ECTlON
�� ' 2516 E/UDUR RD/ HNCH0RHGE, HK 9y��,
276-222i
PE�MlT N3 ( 76587 )
9>`�LICH�7 RO8ERT BX 87l ER 99�77 272-7961
L3CRTJON LHKE SHORE DR
yLEG8L !1 �LK g LHKE HILL HC�ES #6 LOT SIZE 29550 SUUHRE FEET
TYPE GF SO/L RBSORBTl0N SYSTEM IS� TR�NCH
|�HXIM!1M Ki��8ER 0F REDRCS�� = ] SOI
� \ i
�rHE R�GUIRE� SlZE OF THE S0IL HBSORPTIU�� SYSr[M lS\
!HE L��NGTH ���ENSIDN IS THE L E TR�iJCH UR DRHINFIELD
T�E DEPTH OF H TRENC|� UR P7T E� THE SURFRCE OF THE
GR0�ND H�� THE BOTTOM UF TME EXC�YHTION F��T)
THERE �S NO SET W��TH FOR TRENCHES ^
[�iE GR8VEL �EPTH lS THE MlNlMU OF EL BETWEEN T�E OUTF8LL PlPE
R�D T|�E B�TTO� OF THE EXCHYRTI�N`(I�\F�ET) \^
�HCKFlLLING OF HNY SYSTEM HOUT FT �L IKSPFCTl0N HND HPPROYHL 3Y THI�
)EPHRTMENT NlLL BE SU8JECT �O PRDSEC�TION
1I�lMU� DlSTHNCE �ETHEE� H WE 9NY ON-SlTE SEWHGE 0ISPO�HL SYSTEM �S
180 FEET FDR R PRIYHTE WE�L DR 208 FEET FOR R Px8LlC WELL
�S-L LOGS H�E REQU�kED HND MUST BE RETURHEL) l0 THE DEPHRTMENT HITHlN }0 D�YS
�F TK� NELL COMPLETION
�PECIFlC�lIO�S R�D CONST�UCTION �ILHBLE TB l��SURE P9OPER
�MSTHLLHTIUH
Oconstzuction E:7eit J-a�i
"One test is worth a thousand opinions"
2204 Cleveland Anchorage, Alaska 99503
Performed For Robert Chopp Date Performed 6 24 76
Legal nescrintion: Lot 1 Bloc1: B Subdivision Lake Hill &cxesL 6th Add.
This Form Renorts Soils Lon yes Percolation Test_5 _
Denth
_ Feet _ SoiICharacteristics _
2
4 Silty Sandy Gravel (GM)
6 moist
8-
10 - Sandy Silt (ML)
12 moist
q4R_ _ - -
Gravelly Sand (Sp - SM)
16 wet
18-- Bottom of Test Hole
20
Was Ground Water Encountered? yes
If Yes, At what Denth? - 14 feet
I I �
th to
-
.. .. .. I1 au 11 1 /cV ''Ii T1U 6C
Proposed Installation: Seenaoe Pit Drain Field
Depth of Inlet _ Depth To bottom Of Pit Or Th_renc
Cn"""ENTS: — 210 Square Feet Drainage area required Per bedroom.
Test PerformedCertified Sy: coNSTRUCT1oN TEST
�yJames D Mack Date: 6/24/76 i LA
Gross Time
DeninchesH2O plenchesnl
-Reading ---__Date
min.utes
--
-
6713 �atur to
36 0- -
t --
6/24 p' readjus water levelTT
-.- - _ -s_
724- 180
36
L -- ---- - --- -- ---I
12
--- ,
210
- -- --- --_ - - - --- -
6%2- 4-- ---- ---------- --- 240
48 _
49-3/4 1.75
-- ----- -- -
S 1 1-1 4 ----1.5
.. .. .. I1 au 11 1 /cV ''Ii T1U 6C
Proposed Installation: Seenaoe Pit Drain Field
Depth of Inlet _ Depth To bottom Of Pit Or Th_renc
Cn"""ENTS: — 210 Square Feet Drainage area required Per bedroom.
Test PerformedCertified Sy: coNSTRUCT1oN TEST
�yJames D Mack Date: 6/24/76 i LA
MUNICIPALITY OF ANCHORAGE
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. 051-122-75-000
Expiration Date: 9/30/2025
Legal description LAKE HILL ACRES #6 BLK B LT1-A
Site address 22220 ANTHEM PL Chugiak AK 99567
Current property owner(s) WILKINS GREG S
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Er
Original Certificate Date: 11/6/2024
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 X
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval—June 2022
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-122-75
Complete legal description Lake Hills Acres #6 Blk, B Ll -A
Location (site address)
22220 Anthem Place *Chugiak, AK 99567
Current property owner(s) Greg Wilkins
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone 907-242-1683
3. TYPE OF WATER SUPPLY:❑ 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: ❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑■ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 11 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
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 $ ) >� V Waiver Fee $
Date of Payment /0/Z�/2'-I Date of Payment
COSA # -; C 2- `� �"% �/ L% Waiver #
COSAApplinlbn_June 2022
COSA Checklist
Legal Description: Lake Hills Acres #6 Blk B, L1 -A
Parcel ID: 051-122-75
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _
A. WELL DATA
❑■ Well log is filed with Onsite (or attached)
Date drilled 7/26/1977Total depth 81.66 ft
Cased to UNK ft
❑■ Sanitary seal is functioning correctly
X Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 9/30/24
Static water level at beginning of test 10.0 ft
Comments
B. TANK DATA
Measured operating fluid level in septic tank _
Date of pumping Holding Tank
❑ Required maintenance completed, if AWWTS
Comments: see pumping receipts
D. ABSORPTION FIELD DATA
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft
❑ N/A – pressurized field.
❑ Per record drawings, field is insulated.//
❑ Monitor tubes go to bottom of effective
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant o eld not used for more
than 30 days prior to dat of test)
Gallons introduced allons date
Any rejuvenation tr tment (past 12 months)
If yes, ente ate
COSA Checklist June 2022
Well production at time of test 4.7+ gpm
Water storage tank volume—O'gallons
Well disinfected for coliform test? ❑ Yes ® No
❑■ Coliform bacteria is Negative
Nitrate 5.62 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑Q Arsenic less than MRL (ND)
Collected by GEG
Date 9/30/24
C. LIFT STATION
❑ Required maintenance
Age of lift station
Lift station material
Comments:
Ade9dacy test date
esults ❑ Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
E. SEPARATION DISTANCES
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'
NSA
Community Sewer Manhole/Cleanout > 100'
MN ft
Dyes
if No ft
Yes
if No
Neighboring Tank > 100' ni Yes
if No ft
Private Sewer/Septic Line > 25' Q Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No NSA ft
Holding Tank > 100' Yes
if No **75'+ ft
Neighboring Absorption Fields > 100'
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
Animal Containment > 50' Q Yes
if No ft
Yes
if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' 9Yes
if No ft
Q Yes
if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Fields) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' g Yes if No ft Surface Water > 100' 9 Yes if No ft
Tank to Property Line > 5' ❑ Yes if No *0 ft
Field to Property Line > 10' E] Yes if No � L ft
Water Main > 10' ❑- Yes if No ft
Water Service Line > 10' E Yes if No ft
F. ENGINEER'S COMMENTS
Wells on Adjacent Lots:
Private Wells > 100'
Community Wells > 200'
,� Yes if No **75'+ ft
Q Yes if No ft
If tank or field is under driveway comment below
*Waiver granted - Holding tank is in Road Right of Way **Met code at time of install —
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 Engineerinq Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Gamess Date
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
the
practices. The reported results describe the condition of the systems on the date/s of evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may
0�
..
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend
o s
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the of construction (materials and workmanship), and the water usage of the family utilizing
* :" CJ H �*
year), quality
the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
0• • - • • • • • • • • • • • . • • • • • • • • •
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding
the GEG no representation whether an attemative well
P
the future performance of well or septic system. makes
or septic system can be installed on the property in the event either of the current systems fail to perform
.......... ........
% f A. Gar ss: •
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
CE— 79
/�•
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
�P^ea j�\ v�
LfCENSEQ np�0fess+01
COSA Checklist June 2022 #AECC8U
M
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT I'
On -Site Water and Wastewater Section I
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC241440
Subdivision: Lake Hill Acres #6, Block: B, Lot: 1-A
907-343-7904
Fax: 343-7997
A water sample revealed a nitrate concentration of 5.62 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
fPLFWS
Municipality of Anchorage
On-Site Water and Wastewater Program
(907)343-7904
Certificate of On-Site Systems Approval
Parcel I.D. 051-122-75 ZQ
Expiration Date: c>)" l I
1. GENERAL INFORMATION
Complete legal description Lake Hill Acres #6 B-B L-A1
Location (site address) 22220 Anthem PI Chugiak, AK 99567
Current Property owner(s) Greg Wilkins Day phone
Mailing address P.O. Box 670891 Chugiak, AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
[j Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well G Individual []
Individual Water Storage ❑ Holding Tank ❑
Community Class Well El Community ❑
•
•
Public Water System ❑ Public Sewer ❑
WaiverNariance request for:
Distance
Received by: Date:
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ 524, Waiver Fee $
Date of Payment i/M-?-� NV Date of Payment
hh
Receipt Number V 7'3i'i e Receipt Number
COSA? Q,�jr1 Jf is i Waiver#
I
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe. functional and adequate
for the number of bedrooms and type of structure indicated herein. 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Farmer Surveying LLC. Phone 907-745-0222
Address 9131 E. Frontage Rd Palmer, AK 99645
Engineer's Printed Name Ronald E. Godden Date 1I/Z? /1
g000��Upp�
A •OFA4, tip
✓p' • •T, -11 't,r+Pa
6. DSD SIGNATURE p••• ' ' •
P G
System#1 Approved for OQ o
y pp �� bedrooms P tt�n��d E.Gcddm ;•F 135Elgoity..•\ a
System#2 Approved for _ bedrooms Qe4-*". �,•+ #'
Pit2FtDisapproved
Conditional approval for bedrooms, with the following stipulations:
r'`�'� •� ,�'
- ON-SITE -.
WATER AND
WAS I1_WAThR
1 PROGRAM
By: Original Certificate Date: t
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 professional civil engineer registered in the State of Alaska, The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
cos,•U Le sheet i
If more than 1 septic system is on the liot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Lake Hill Acres #6 B-6 -A1
Parcel ID:051-122-75
A. WELL DATA
Well type
Private if A, B, or Cprovide PWSID# N/A Y
Well Log(YIN)
Date completed 7/26/77 Sanitaryseal Y/N Y Y
( ) Wires properly protected(Y/N)
Total depth 81.66 ft. Cased to 40+ ft. Casing height(above ground) 31 in.
•
FROM WELL LOG AT INSPECTION
Date of test 7/29/77 11/19/2018
Static water level 15 ft. 18 ft
Well production 50 g.p.m. 5.8
g.p.m.
WATER SAMPLE RESULTS:
Coliform A colonies/100 mL Nitrate 4.23 mg/L
Arsenic A ug/L Date of sample: 11/19/2018 Collected by: Kaley Lyles
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Holding/Steel 8/30/2013
Date installed
4000 1
Tank size gal. Number of Compartments 1 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm(YIN) Y
Date of pumping 10/5/2018 Pumper JR's Pumping
f.
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type
•
Length ft. Width . Gravel below pipe ft.
Total depth ft. Eff absorption area Monitoring tube Depression over field
Date of adequacy test
4 Y '-suits(Pass/Fail) For bedrooms
Fluid depth in absorption field befor= -st in. Water added gal. New depth in.
Elapsed Time: r' . Final fluid depth in. Absorption rate >= d
9P
Any rejuvenation =-tment(past 12 mo.)(Y/N&type) _ If yes,give date
V
D. LIFT STATION
Date installed Size in gallons Manhole/Access(Y/N)
"Pump on"level at in."Pump off'level at in.High water alarm level at
in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot Nip` On adjacent lots >100'
N/A >�00'
Absorption field on lot
On adjacent lots
Public sewer main N/A Public sewer manhole/cleanout NSA
Sewer/septic service line >25 Holding tank >75'
Animal containment areas >50' Manure/animal excrete storage areas >1 00'
SEPTIC/HOLDING TANK ON LOT TO:
>5'
Building foundation Property line >5' Absorption field NSA
Water main N/A Water service line >�0� Surface water >100'
Wells on adjacent lots >75'
ABSORPTION FIELD ON LOT TO:
Property line __Building foundation Water main
Water Service line Surface water Driveway,parking/vehicle storage
Curtain drain __Wells on adjacent lots
F. COMMENTS
Survey On File
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and 4z,
P .°pF••A� q��
review of Municipal records that the above systems are in P S'C°° ° **•,.'j o
conformance with MOA COSA guidelines in effect on this date. ff f, •4• 'H / °•.° s
Engineer's Printed Name Ronald E. Godden �•• ° •� • 0
Date 12Z 12 ... •°.. . d,
ot, Ronald E. Godden
CE 8�(S ; g.`
4LIFESSI a`�
�b4�odoQa�
COSA canary sheet_2-6-'5.doc
C.
Municipality of Anchorage° <
On -Site Water &Wastewater Program
(907)343-7904
CERTIFICATE OF ON—SITE SYSTEMS APPROVAL
Parcel I.D. 051-122-43- Expiration Date:
' r
1. GENERAL INFORMATION ¢f
Complete legal description LAKE HILL ACRES S/D #6. BLOCK B LOT 'X( —�
Location (site address) 2_1� ANTHEM PLACE, EAGLE RIVER, AK, 99577
-- a 2')- O
Current Property owner(s) GREG WILKINS Day phone 242-1638
Mailing address P.O. 670891, CHUGIAK, AK, 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING
Single Family (w/wo ADU) j 61
ei , a
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex) APR 10 2014
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
❑
Individual Water Storage
❑
Individual Holding tank
Community Class Well
❑
Community On-site
LJ
Public Water System
❑
Public Sewer
❑
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ q7 q -o /
Date of Payment `� !nn�''rpp11
Receipt Number
COSA #
Waiver Fee $ C2/15
Date of Payment Ali // Ll
Receipt Number �L/�0(�� l
Waiver ft QS+—��>'�%7U
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. /further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
in conducting this evaluation, GEG, UD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance ofthe
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the controf of the evaluator of the system Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any fagot right whatsoever
6. DSD SIGN
System #1 Approved for A bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
337-6179
Date 't1 ofit!
".Je,r/r y A. Garnerss.r
V ZE-79153
WPro f e s sia�o,
bedrooms, with the following stipulations:
t,� kOFtA&C.
ON-SITE
WATER AND
K1;, _-rc\NATER
By Original Certificate Date:
r
Theniri lib nchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS: rr
COSA Checklist V Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
IR- 111151
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system .
Certificate of On -Site Systems Approval Checklist
LAKE HILL ACRES S / D 6; BLOCK B, LOT �4
Legal Description: � � �'/� Parcel ID: 051-122-4+
A. WELL DATA *ASSUMED BASED UPON SURROUNDING WELL LOGS.
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 7/26/1977 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 81.66 ft. Cased to *4D'+ ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 7/29/1977 3/12/2014
Static water level 15 ft.
Well production 50 g.p.m. 2.87 g.p.m.
WATER SAMPLE RESULTS: **COULD NOT REMOVE WELL CAP.
Coliform ,&� colonies/100 ml. Nitrate )43 mg./L. Collected by: GEG, Ltd.
Arsenic: No ug./L. Date of sample: 3/13/2014
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material HOLDING/STEEL
Tank size 4000 gal. Number of Compartments
Foundation cleanout (Y/N) YES Depression over tank (Y/N) 120
Date of pumping SEE ATTACHED
C. ABSORPTION FIELD DATA
Pumper
Date installed Soil rating (g.p.d./ftor ft2/bdrm)
Length ft. Width
ft.
Total depth ft. Eff. absorption area_ ft2 Monitoring tL
Date of adequacy test Results ails) —
Fluid depth in absorption field before _ in. Water added
Elapsed Time: n. Final fluid depth _ in.
rejuvenation treatment (past 12 mo.) (Y/N & type)
Date installed 8/30/2013
Cleanouts (Y/N) YES
High water alarm (YIN) YES
JR'S PUMPING
System type _
Gravel below
Depression over field
ft.
For bedrooms
gal. New depth _in.
Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access
"Pump on" level at in. "Pump off' level
E. SEPARATION DISTANCES
level at
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot N/A On adjacent lots
Absorption field on
Public sewer main
Sewer /septic service line 25'+
On adjacent lots
100'+
100'+
Public sewer manhole/cleanout N/A
Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON. LOT TO:
Building foundation 5'+ Property line d'+ QFC Absorption field N/A
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 75'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Building foundation Water
Water service line
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Surface water
Wells on adjacent lots
-
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date
(Rev. 11105)
parking/vehicle storage
Municipality of Anchorage
Community Development Department p
Development Services Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.rnuni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # 141124
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block B, Lot 1-A
of Lake Hill Acres #6 subdivision. This inspection revealed a nitrate
concentration of 5.63 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
•
April 10, 2014
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Ak
Ref: Waiver Request for Lake Hill Acres 46; Block B, Lot 2
To whom it may concern:
We are requesting a 0 foot lot line waiver from the holding tank which was installed on 8/30/13 to
the east lot line. The tank was originally installed on property, however, after subdividing the lot
a portion of the east lot was given to right-of-way which resulted in the holding tank approximately
being 5 feet off property. There are nc septics nearby as Anthem Place borders the east property
line.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you Hae any questions, please contact us at 337-6179. Thank you for your assistance.
i
inc ely� p
.E., M.S.
3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 `Fax: (907) 338-3246 * Website: www.garnessengineering.com
Municipality of Anchorage
Development Services Division
On -Site Water and Wastewater Program
n ent
a`
Department
**** VARIANCE/WAIVER REVIEW ****
Waiver#: osp141070 COSA#: osc141124 Permit#:
PID#: 051-122-76
Legal Description: Lake Hill Acres #6 Block B Lot 1-A
Engineer: Garness Engineering Group
Applicant: Greg Wilkins
Your request for a waiver of the required 10 feet horizontal separation from the holding tank to
the property line has been approved. The approved separation distance is 0.0 feet.
This waiver approval applies to the existing holding tank only. Any future upgrade to the on-site
wastewater disposal system will require all separation distances be met or another approval from
this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
Mleft"M
❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
...............................................................................
Waiver is Granted: X Waiver is not Granted:
Date: T ' I I Approved to
viewer ✓✓✓
........................................... .. .......................
rA�
ASBUILT
I HEREBY CERTIFY .THAT i HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY:
!lAife?'i,�/Gc' �Gri'�"'.5�i: 4�,S/Y.+�✓. ,:iA.%�1'. '
AND THAT NO FNCROAbHMENTS @`XIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
EASEMENTS, COVENANTS., OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
I�
_ SM4ARD &ASSOCIATES LAND SURVEYING 694-08
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MUNICIPALITY OF ANCHORAGEOepaitme4nt Community Development Department cRight of Way Section
ENCROACHMENT PERMIT R141256
THIS AGREEMENT, made this I Ph day of April, 2014, by and between Greg S. Wilkins
and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality
of Anchorage; a municipal corporation organized and existing under its Charter and the laws of the
State of Alaska, hereinafter called the "PERMITTER".
WITNESSETH:
WHEREAS, PERMITTEE is the owner of the following described real property:
LAKE HILL ACRES #6, BLOCK B. LOT 1-A, according to the official records
thereof, on file in the office of the District Recorder, Anchorage Recording District,
Alaska, and;
WHEREAS, PERMITTER owns and/or maintains the real property more particularly
described as follows:
The 55 FOOT RIGHT OF WAY OF ANTHEM PLACE, immediately to the east of
PERMITTEES property as shown on Plat No. 2013-112, on file in the office of the
District Recorder, Anchorage Recording District, Alaska, and;
WHEREAS, PERMITTEE has placed a septic holding tank upon the referenced real property
which encroaches 5 feet upon the PERMITTER'S Anthem Place Right of Way.
NOW, THEREFORE, it is mutually agreed between the parties hereto that:
I. The PERMITTER, acting through the Director of Community Development
Department, hereby grants to the PERMITTEE the privilege of allowing a
septic holding tank to encroach 5 feet upon the PERMITTER'S Anthem Place
Right of Way, as shown on "Attachment A," included herewith.
2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless,
the Municipality, its officers and employees, from any and all lawsuits, claims
or actions brought to any person for or on account of damage to property or
injury, disease, illness or death of persons, including all costs and expenses
incident thereto, arising wholly or in part from or in connection with the
existence of, alterations, maintenance, repair, renewal, reconstruction,
operation, use or removal of the encroaching septic holding tank, as placed
upon the PERMITTER'S Anthem Place Right of Way.
3. The PERMITTEE shall not assign or transfer any of the rights granted herein to
another individual or company without first notifying and securing the approval
of the Director of Community Development Department.
4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S
real property whatsoever, except only the encroachment rights described herein.
5. The PERMITTER reserves the right to revoke this permit upon twenty (20)
days written notice to the PERMITTEE. The PERMITTEE agrees upon such
notice of revocation, to move said encroachment(s) from the Anthem Place
Right of Way in which it is placed. Should the PERMITTEE refuse or fail to
comply with said written notice, the PERMITTER may, without further notice
to the PERMITTEE, remove or cause to be removed the encroachment(s), and
the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs
incidental to the removal thereof.
In addition to the mutual promises heretofore made, the PERMITTEE hereby promises to pay
the PERMITTER a one-time permit fee of $115.00.
IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day
and year first hereinabove written.
GRANTEE:
GRANTOR: MUNICIPALITY OF ANCHORAGE
ack L. Frost, Jr.
Right of Way Supervisor
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this 14k�k day of Ap:�� , 2014, before
me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as
such, personally appeared Jack L. Frost, Jr., known to me to be the Right of Way Supervisor for the
Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to
me that he executed said instrument as the free and voluntary act and deed of said corporation for the
uses and purposes therein mentioned, and that he was authorized to execute said instrument.
WITNESS my hand and official seal on the day and year first above written.
.VIRE W }-q�T..,,
;•�►OTARY•.•
PJ8L1G
t.
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
NOTARY PUBLIC in and for Alaska
My Commission Expires: 414 L 11
THIS IS TO CERTIFY that on this 18day of A -P 2014, before
me, the undersigned, a Notary Public in and for the State of A aska, duly commissioned and sworn as
such, personally appeared Greg S. Wilkins, known to me to be the individual named herein who
executed the foregoing instrument, and he acknowledged that he did so freely and voluntarily for the
used and purposes therein mentioned, and on oath stated that he was authorized to execute said
instrument.
WITNESS my hand and official seal on the day and year first above written.
U t, a -k
urrirr�t' NOTARY PUBLIC in d for Alaska
WYq� My Commission Expires: Q h 1l-?
AUBLIG tc: ti
or