HomeMy WebLinkAboutLAKE HILL ACRES #1 LT 3
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
~"~sc~'~'°"W ~ ~/~ ~11 ~ /~m~p,~
LOCATION
EW
~PGRADE
DISTANCE TO: / Absorpti0.o.o~ a~ea I Dwelling
Manufacturer Mater~-'~
Inside Width
Liq. capacty n length
IF HOMEMADE:
Well
DISTANCE TO:
Manufacturer
DISTANCE TO: ' Well
No. of lines Length of each Jjne
of tile to/finish ~ ~
grade
NO. OF BEDROOMS
PERMIT NO.
No. of compartment~
-Liquid depth
Dwelling PERMIT NO.
Liquid capacity in gallons
Foundation
Length Width
Type of crib Crib diameter
DISTANCE TO:
Well
Total length of I~¢~ /
Material beneath the
Depth
Material
.~ (-~inch es
Crib depth
inches
Building foundation
PERMITNO. (~30/O V(
Distance between ,~¢/,¢
Total effective absorption area
PERMIT NO.
Total effective absorption area
Nearest lot line
i Depth Driller Distance to lot line
DISTANCE TO: Building foundation Sewer line Septic tank
PERMIT NO.
Absorpt on area(s)
OTHER
PiPE MATERIALS
SOIL TEST RATING
REMARKS
DATE LEGAL
by
DOC Co. dba
SULLIVAN WATER WELLS
P. O. BOX 272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
OWNER OF LAND
ADDRESS ~
LEGAL DESCRIPTION
DA TE - Started ~////
PERMIT NUMBER
DEPTH OF WELL
STATIC LEVEL oF WATER
U~AW DOWN FT.
Ended -~//Y//~'~ GA~. PER HR
KIND OF CASING
KIND OF FORMATION:
From O Ft. to ~)
From ,~-') Ft. to t o
From .t/) Ft. to ,5~ ,7.?
From __ Ft. to
From ~:,.f" Ft. to
From Ft. to
From '~? Ft. to ~ /~'
From~.Ft to
From ~ / $> Ft. to ..
From Ft. to
From {-~0 Ft. to t(?~
From ~ {;oe~ Ft. to/ 70
From /?[) Ft. to /74
From .Ft. to
From Ft. to
From Ft. to
Ft.
Ft.
Ft.
Ft. ~/ ~; ~ ,C~ ~ From~
Ft .... ~')~,,/0 /f (~ *7~r~ '~,,, From
Ft. ,:..,Li'~ 27~,¢;,.:~'~ L. From
Ft. · ~)~ 7~/2~,- From
Ft. From
Ft. From
From__Ft. to.__Ft.
From Ft. to / /Ft./ ' ~
From Ft. to Ft.
From Ft. to____Ft.
From__Ft. to Ft.
From Ft. to Ft.
From Ft. to _Ft.
From__Ft. to Ft.
Ft. to Ft
Ft. to Ft.
Ft. to ' Ft.
Ft. to Ft..
Ft. to__Ft..
Ft. to__Ft
Ft. to Ft.
Ft. to Ft.
Ft. to Ft.
MISCL. INFORMATION:
PERMIT N0.
APF'L I CANT
LOCAT I ON
LEGAL
[:,RLE WJRMLI::, 222i MULDOON RD. SPACE ~28 2:=::]-':-412:±
LOT ]: LAKE HILL ACRES 1SI' AD. LOT SIZE 22:0C'~0 SQLIARE FEET
TYF'E OF SOIL RESOF.'F'TION SYSTEM IS' TRENE:H
MRXIMLIM NJME, ER OF BE[:,F.:OOMS ~:
SOIL RRTING (SQ FT.B~..-
THE REQLIIRED SIZE OF THE SOIL HB-,_RFTIUN =,T_,TB1 lb]:
[:,EF'TH= ::L ~.~ LEf4G'TH= '~C1 , ..... _-.
_~IRFI .~. EL [:,EF"TH=
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFACE OF 'THE
GROUND AND THE BOTTOM OF THE EXCR9ATION (IN FEET).
THERE iS NO SET WIDTH FOR TRENCHES.
'THE GRAYEL DEPTH IS THE MINIMUM DEPTH OF GRRYEL BETWEEN THE OLITFRLL PIPE
AND THE BOTTOM OF THE EXCAMATION (IN FEET).
F-:EG!LI ][ F-:E[:. SEPT T C: TRf4k] S I ZE= ±C~C~E, f~RLLC~F~S
PEF.:MIT RPPLIC:AN'F HAS THE E.E-,F_N=,IBILITT TO INFORM THIS DEPRRTt"IENT DURING THE
INSTALLATION INSF'ECTIONS ~"~F ANY WELLS AD.TRCENT TO THIS FR_FERT'r' 'n ' ' "AND THE
NUMBER OF RESI[:,ENr:ES THAT THE NELL WILL SERVE.
TktO ( ':: ) F-:Eg!U~ Z F-:E[:,
z Z h~SF'EC:T' t- ,314S; RE:E
- , , ,i-iI, I-
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION RND HFFR_,'HL BY THIS
DEPRRTMENT LqILL BE SUB.TECT TO F'ROSEC:UTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
±00 FEET FOR R PRIVRTE WELL OR ±50 'TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC NELL.
MINIMUM DISTANCE FROM R F'RIVRTE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIRGRRMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F"EF:i"I I 'T E::-::P I F:Es [:,EC:EPlE:EF-: Z::t.. 19:3Z::
I CERTIFY THRT
t: I RM F'RMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
~: i UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
Y4. 0
fi~:UN~:, F~ND THE DC~TTOlq OF THE E~0::RVEITION (iN
!E C~g:FiVEL DEF'TH ZS THE I~H~HLR'i DEF'TH OF O~RVE. L DETHEEN THE OLri'FFfi_L
:EET FOF~ R F',RiL,'RTE biELL C:¢: J~,O TO 200 FF:ET F~rCq'i Fl F'U~:LIC NELL DEF'Er.~ING
~HE TYPE OF ¢'~='~ ~
· ~.c,~. C; NELL.
I;'LL ~NE-TFfI.L THE E.'¢STEI'~ iN fiCCOF::DRI4CE N]TH TFfE COPES.
AF'F'L.'~ C:F~/~? DRLE t40RMUS
E'V / Z' l-~'1d- V ~z-~=~<~.~'~? r'~.~ ~-.i ~i x~ ~ ~./4, e~
O & E ENG,REERING & DEVELO, MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster Earl Ellis
694-2774 SOIL LOG 688-2280
Performed for: Name: ~/~.~ D.'~cf-~--- {4//~'4~/'//'"~ Tel'N°'?~-~'~--~//"~'/
Mailing Address: ~"¢~ J ~/~-- -~ ~': ~'~,--
Legal Description: ~ ~'~ G / ~ ~ ~-~ ~"~ ~ ~5, ~, ~ ~ ~ '~
Depth (feet) Soil Characteristics /
13__
14__
16
Ground Water Encountered: Yes No
~ If yes, what depth
Proposed Installation: Seepage Pit Drain Field.__
Comments:
PLOT PLAN
~ PERC. TEST
- t55u�-�'
•
•, r Municipality of Anchorage 0.A4
On-Site Water and Wastewater Program '1011 h •
(907) 343-7904 SA E
Certificate of On-Site Systems Approval
Parcel I.D. 051-052-03 Expiration Date: 3 -.2q-IF
1. GENERAL INFORMATION:
Complete legal description Lake Hill Acres#1; Lot 3
Location (site address) 22706 Old Glenn Highway*Chugiak,AK 99577
Current Property owner(s) Steven&Lori Scott Day phone 242-8197
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received b _ Date: bl1'?--
COSA to be released to t e gr,unless otherwise requested by the engineer.
COSA Fee $ 2 Waiver Fee $ oC(c--
Date
cDate of Payment 9 "-5--/ 7 Date of Payment q CI
Receipt Number (7(9 6dr, T 6 Receipt Number c G
COSA# Cis( (71 Waiver# n.S V 17(0 (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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: 12).7- 6 ii 7"
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o00 OF /..
in accordance with the guidelines and regulations established by the Municipality of Anchorage and o l
industry practices. The reported results describe the condition of the system/s on the date/s of the • ..-• `•(.. 540
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or '.4`.1.
' ' 0O
encroachments may exist that were not identified during the evaluation. The operational life of all wells �: 4-n T /` ..o0
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, D
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and 0..1/4„.„... .,, . . I are outside the control of GEG. Satisfactory test results do not guarantee future performance of theJ r: . .. :ss;• a
system/s; therefore, GEG makes no warranty(express or implied)regarding the future performance of V g r
the well or septic system. GEG makes no representation whether an altemative well or septic system 00 4,i` i• E— 953 ,gip
can be installed on the property in the event either of the current systems fail to perform adequately in kIT " _ ..1,-.2.,) 3.11 ooO
the future. The content of this report is for the sole benefit of the person/party that retained GEG to gQPa p • ••ct6,b1.1o\
perform the evaluation. Reliance upon the information provided in this report by any other person or �Q` ' Oco
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
_=v _ \- CAE Ccs"
6. DSD SIGNATURE !2 ONS NO
-� RP z�
System #1 Approved for 3 bedrooms \NIWPS-���NP�M
System #2 Approved for bedrooms :� 9900 O
�c.�
Disapproved
o'MENT S+S
Conditional approval for bedrooms, with the following stipula ions:
( (..0 er-(Lc---ravv\AC cti- 17----(‘.6(d Cx1/'e Y'y ect.Vs-S 0(
-Q. t` e a (c .
�`'�-P � �f �a��c i� sac Pam �-(c '
By: =��/- / ) 2=2-i-11 Original Certificate Date: - -
9 I ( ( 7'
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 \, Nitrate Advisory X
Septic System Advisory Y Arsenic Advisory
Well Flow Advisory Other •
COSA blue sheet_10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: LAKE HILL ACRES #1; LOT 3 Parcel ID: 051-052-03
A. WELL DATA *PER ASHLEY AT SULLIVAN WATER WELLS ON 8/21/2017 (SEE ATTACHED EMAIL).
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) Yes
Date completed 3/16-17/1983 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes
Total depth 174 ft. Cased to *173.08ft. Casing height(above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 3/16/1983 8/10/2017
Static water level 147 ft. Unknown ft.
Well production 10 g.p.m. 3.1+ g.p.m.
WATER SAMPLE RESULTS:
Coliform F' &colonies/100 ml. Nitrate (0• ?Smg./L. Collected by: GEG. Ltd.
Arsenic: < 5 ug./L. Date of sample: e/101(-4- � t2../-2., )13.
B. SEPTIC/HOLDING TANK DATA 34 YEAR OLD STEEL SEPTIC TANK IS APPROACHING THE END OF USEFUL LIFE.
Tank Type/Material SEPTIC/STEEL Date installed 5/23/1983
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes
Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A
Date of pumping 6/27/2017 Pumper JR'S PUMPING SERVICE
**NEW MONITORING TUBE ONLY EXTENDS 88" (7.34')
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE AT NEW MT BELOW INVERT OF NEW CLEANOUT.
(ASSUMED 8' OF DRAINROCK)
Date installed 5/23/1983 Soil rating (g.p.d./ft'or t'/bdrrr 265 System type DEEP TRENCH
Length 63 ft. Width 2.5 ft. Gravel below pipe **7.34 ft.
Total depth *12.5 ft. Eff. absorption area UNK ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 8/10/2017 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test**73 in. Water added 578 gal. New depth**92 in.
*****
Elapsed Time: 120 min. Final fluid depth 87 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) None Known If yes, give date —
***LIQUID LEVEL (LL) AT 15.1" BELOW INVERT OF NEW CLEANOUT (CO). ****LL 0 4" ABOVE INVERT OF THE DISTRIBUTION
LINE IN NEW CO. LL 0 1" BELOW INVERT OF DIST. LINE IN NEW CO. LL WAS FOUND TO BE AT 80.75" AFTER 24
HOUR RECOVERY READING. TANK WAS NOT PUMPED PRIOR TO TEST AND HOMEOWNERS WERE ASKED TO MODERATE WATER
USAGE OVERNIGHT AND FOR THE NEXT DAY . RECOMMEND A 90% ADVISORY LETTER FOR THE DRAINFIELD.
D. LIFT STATION
Date installed Size in gallons Manhole/Access(Y/N)
"Pump on" level at in. "Pump off'level at '• a er alarm level at in.
- •• Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot *100.33 On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75 + Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ 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 *5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots **98.8'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *7'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain None Known Wells on adjacent lots 100'+
F. COMMENTS
*See attached waiver request.
**Existing waiver for lot to north, Lake Hill Acres #1; Lot 3 (WR#940026)
ooboop0
G. ENGINEER'S CERTIFICATION OF AL vQ
I certify that I have determined through field inspections and p° 49 H .*.7*0
review of Municipal records that the above systems are in ; QD
conformance with MOA COSA guidelines in effect on this 0
date. ./
Q ...J.ff ey. . -,s.:
Engineer's Printed Name JEFFREY A. GARNESS QO 9, 7. •�' •53 oap�
s "i/^•`:2g
Date 12126/1 q- �4i,':,e •.i.'L1.2 Ro
' aProfessioc`t:
#AECC884
(Rev.11/05)
• Municipality of Anchorage•
u ,
_ Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Septic System Advisory
Certificate of On-Site Systems Approval # OSC 171404
During a recent adequacy test on the septic system for Block , Lot 3 of
Lake Hill Acres #1 subdivision, 87 inches of standing water was observed in
the absorption field. This indicates that approximately 90+% of the
absorption area is inundated. Although this system passed the adequacy test,
the remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval
•
Municipality of Anchorage •
p4 fvyY i.
• .� Development Services Department ,..,.. °
Building Safety Division ` losin
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC 171404
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
3 of Lake Hill Acres #1 subdivision. This inspection revealed a nitrate
concentration of 6.35 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.
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.
•
7:::, l<•r. Municipality of Anchorage °t _ `
On-Site Water and Wastewater Program GE 9L
(907) 343-7904 s
Certificate of On-Site Systems Approval
Parcel I.D. 051-052-03 Expiration Date: 1 — IF 1 7
1. GENERAL INFORMATION:
Complete legal description Lake Hill Acres#1; Lot 3
Location (site address) 22706 Old Glenn Highwav'Chuaiak,AK 99577
Current Property owner(s) Steven &Lori Scott Day phone 242-8197
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual El
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: l.-c Lt -JF - j \.46t4L --i--z) 4 Distance:
Received by:, Date: 9kJ/4
COSA to be rel--sed to the engineer,unless otherwise requested by the engineer.
COSA Fee $ 52.43 Waiver Fee $ 21S
Date of Payment q 1511? Date of Payment q1��/
Receipt Number ) 660(046 Receipt Number aeti
'1/
COSA# (V)0 1106/ Waiver# 05V1-4.10(47
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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 f
Engineer's Printed Name: Jeffrey A. Garness Date: i3 13 i it
oo�000D44
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system OFA L J��
in accordance with the guidelines and regulations established by the Municipality of Anchorage and ,„t7, -,....•. .., nn
industry practices. The reported results describe the condition of the system/s on the date/s of the p P..' • S'U4nn
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or f .��T �,, SUV
encroachments may exist that were not identified during the evaluation. The operational life of all wells i , *VD
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 0 t7
groundwater levels (that may fluctuate during the year), quality of construction (materials and 4 J ! VA
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the O(/ J f 1 frA. - -= s:' 0
system/s;therefore, GEG makes no warranty(express or implied) regarding the future performance of do 0 •
/ E-7g5 .' ,. 7
the well or septic system. GEG makes no representation whether an alternative well or septic system v0 ' . (� \�'p
can be installed on the property in the event either of the current systems fail to perform adequately in 4V,,,- •... Cso
the future. The content of this report is for the sole benefit of the person/party that retained GEG to 4�Pap�ofesslo�°oma
perform the evaluation. Reliance upon the information provided in this report by any other person or `� \���, ,QaQo
party (including subsequent property purchasers) is not authorized, nor will It confer any legal right `�\\, \r O y(,;�
whatsoever. •` p1-I1 <<,�
`jG$ # c884
6. DSD SIGNATURE `g ON-SITE "
`,--, WATER AND rn
/ `" System #1 Approved for I bedrooms :.-o
;1T3 WASTEWATERz�
System #2 Approved for bedrooms PROGRA% M �=
Disapproved '�,p'O�
NN��
Conditional approval for bedrooms, with the following stipulat vi 05•'
�_ ki4. S /C - ri`et0( — 3Y�-�. 'd
S€ Ec__. `-- k okl e I' S 2,6,-ikavc,c' rr
By: 1 ..- '-- i -/' - / Original Certificate Date: ( ~ i —< 1
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 woik.
7. ATTACHMENTS:. ' .
COSA Checklist Nitrate Advisory •
Septie•Systerri Advisory Arsenic Advisory .
Well'Flow Advisory _ Other • '
COSA blue sheet_1 0-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: LAKE HILL ACRES #1; LOT 3 Parcel ID: 051-052-03
A. WELL DATA *PER ASHLEY AT SULLIVAN WATER WELLS ON 8/21/2017 (SEE ATTACHED EMAIL).
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) Yes
Date completed 3/16-17/1983 Sanitary seal (YIN) Yes Wires properly protected (Y/N) Yes
Total depth 174 ft. Cased to *173.08 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 3/16/1983 8/10/2017
Static water level 147 ft. Unknown ft.
Well production 10 g.p.m. 3.1+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate 4-4 mg./L. Collected by: GEG. Ltd.
Arsenic: C5 ug./L. Date of sample: 8/10/2017
B. SEPTIC/HOLDING TANK DATA 34 YEAR OLD STEEL SEPTIC TANK IS APPROACHING THE END OF USEFUL LIFE.
Tank Type/Material SEPTIC/STEEL Date installed 5/23/1983
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes
Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A
Date of pumping 6/27/2017 Pumper JR'S PUMPING SERVICE
**NEW MONITORING TUBE ONLY EXTENDS 88" (7.34')
C. ABSORPTION FIELD DATA
BELOW EXISTING GRADE AT NEW MT BELOW INVERT OF NEW CLEANOUT.
(ASSUMED 8' OF DRAINROCK)
Date installed 5/23/1983 Soil rating (g.p-d./ft`orCt`/bd265 System type DEEP TRENCH
Length 63 ft. Width 2.5 ft. Gravel below pipe **7.34 ft.
Total depth *12.5 ft. Eff. absorption area UNK ft'' Monitoring tube YES Depression over field NO
Date of adequacy test 8/10/2017 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test**73 in. Water added 578 gal. New depth**92 in.
*****
Elapsed Time: 120 min. Final fluid depth 87 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date —
***LIQUID LEVEL (LL) AT 15.1" BELOW INVERT OF NEW CLEANOUT (CO). ****LL C 4" ABOVE INVERT OF THE DISTRIBUTION
LINE IN NEW CO. LL 0 1" BELOW INVERT OF DIST. LINE IN NEW CO. LL WAS FOUND TO BE AT 80.75" AFTER 24 HOUR
RECOVERY READING. TANK WAS NOT PUMPED PRIOR TO TEST AND HOMEOWNERS WERE ASKED TO MODERATE WATER USAGE
OVERNIGHT AND FOR THE NEXT DAY . RECOMMEND A 90% ADVISORY LETTER FOR THE DRAINFIELD.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off" level at .• wa er alarm level at in.
- Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot *100.33 On adjacent lots 100'+
Absorption field on lot-- 100 +' On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ 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 *5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots **98.8'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *7'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain None Known Wells on adjacent lots 100'+
F. COMMENTS
*See attached waiver request.
**Existing waiver for lot to north, Lake Hill Acres #1; Lot 3 (WR#940026)
4
G. ENGINEER'S CERTIFICATION a, ..o.
F...i C• \\IN
O ` • 1 QO
I certify that I have determined through field inspections and4 9 TH % w�O
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date. g
vO •Je i r r •. Gar ess:
0�
Engineer's Prin ed Name JEFFREY A. GARNESS �. 'I! —••5 o`p
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Date 3// ooeap•�13�
�ofessio�o0
�D�O000��
#AECC884
(Rev.11/05)
•
• Municipality of Anchorage•
i i Development Services Department-
r�=
Building Safety DivisionSA E`T� F
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Septic System Advisory
Certificate of On-Site Systems Approval # OSC 171404
During a recent adequacy test on the septic system for Block , Lot 3 of
Lake Hill Acres #1 subdivision, 87 inches of standing water was observed in
the absorption field. This indicates that approximately 90+% of the
absorption area is inundated. Although this system passed the adequacy test,
the remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval
Municipality of Anchorage '
epar[moil
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV171098 COSA#. OSC171404 Permit#:
PID#: 051-052-03
Legal Description: Lake Hill Acres #1 Lot 3
Engineer: Garness Engineering Group
Applicant: Steven & Lori Scott
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 7.0 feet. In addition,
your request for a waiver of the required 100 feet horizontal separation from the septic tank to
the private well on this lot has been approved. The approved separation distance is 99.0 feet.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
n The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection 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: '1/11/62011 Approved by: ted (7/
"""t 7/
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
•
t.' . uanics
GARNESS ENGINEERING `Y AO, �c�� f'cvtment Systern GROUP, Ltd «r ,
CIVIL&ENVIRONMENTAL ENGINEERS Dealer
August 31, 2017
Municipality of Anchorage
Development Service Department
On-Site Water& Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Lake Hill Acres#1; Lot 3
To whom it may concern:
The septic system serving the subject property was installed in 1983 and is located approximately
8 feet from the east property line(adjacent to road right-of-way). In addition, the well serving the
subject lot is located approximately 100.33 feet from the first cleanout in the septic tank serving
the subject property (see as-built survey). We request that your department issue a waiver of the
required separation distance from a drainfield to a lot line from 10 feet, down to 7 feet. We also
request that you waive the required separation between the well and septic tank down to 99 feet.
Justification for these variances are as follow:
-The encroachments have existed for approximately 32 years(since 1983).
-The property line is shared with the road right-of-way.
-Recent water samples indicated no bacteria present and nitrate levels of 4.4 mg/L.
As can be seen there is minimal risk in granting this waiver. We are unaware of any adverse
impacts associated with issuance of these waivers. Please call or email if you have any questions.
di ely,
, 076
e fr: . arness, P.E., M.S.
Pres�-e
3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246"Website: www.garnessengineering.com
4 co S1 e.
, Frontier Surveys,LLC Project No:17-215 Date:August 22nd,2017
ScaleNOR I I Ordered By:Steven E.Scott Plat:64-90 Grid:N/A
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/ Lake Hill Acres Addition#1
�� Lot 3 Ac.
y! d' 16,997 sq.ft.+/-
/ s.o s 22706 Old Glenn Highway
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Electric Meter/Outside Power t-(Z, Telephone Pole
I- Gas Meter ® Deck -¢ Fence -*' Light Pole 0 t6 30 60
•,S Septic ' Water Well re Mailbox —a.—Over Hanging Power ill f=eel
General Notes:
1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law.
2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey.
3.All measurements/setbacks are to the visual/apparent building footprint.
4.Dimensions to property lines are plus/minus(lift.
..4k•e'`•It,N, This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and
OF 114 '14 conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any
41,
:c1. .......••of ,!/ inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine
41,..:c1.1.
,• the existence of any easements,covenants,or restrictions which do non appear on the record plat.Under no
..:1•Y:•• 1" 4 circumstances should this document be used for construction or for establishing a boundary or fence line.
�;;49T.� •.-p ,y
' * • • * 0 As-bum Survey
= �Q_ • Lot 3, Lake Hill Acres Addition#1
FAEDERIC W.WAGNER: 1 I,Frederic Wagner,hereby certify that this Mortgage Inspection Survey was performed by me,or
•
f •.•• 9g46 • under my direct supervision on August 22nd,2017.
0 4 zt391'7.•'•• a
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pia VP4• Frontier Surveys,LLC FRONTIER,
`�` �� 650 W.58th Ave.Suite E Anchorage,Alaska 99518
w� 907.460.1686-info@frontiersurveys.com
PROFESSIONAL SEAL www.frontiersurveys.com t
. APPLIC ~IT FILLS OUT UPPER HAL. ~ONLY
Property Owner .~_~// ._/~_~ /'.~'~,2_.~.:._ ........ <..:~/ Phone
Mailing Address Zip Code
Address :~ ': : I ~>:./"/,. /2~¢:.
Lending institution /// /7//~ Phone
Address Zip Code
Realty Co. & Agent ..- ~ _ .~-. ,
Address ]~.~ ,~>.:../ /4' >-~ ~' Zip Code
Legal Description ~ ~?'~ ..~ ~.. ~', ~,.~ ~'~J
Street Locat,o~ I: 7- ,-,-'.-~'~>/
Type of Residence
[~ingle Family
[] Multiple Family No. of Bedrooms
[] Other
Water Supply
[~'ndividual A~-~ACH WELL LOG. A well log is required for ali wells drilled since June 1975.
[] Community For wells drilled prier to that date, give well depth (attach log if available).
[] Public Utility
Sewer Disposal
[:~ndividual Year Individual Installed:
[] Public Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Inspector Inspector Inspector Inspector
( ~PROVEB BEDROOMS *CONDITIONS OF APP~'~u~e~tal PrOtection,,
( ) DISAPPROVED
( ) CONDITIONAL
Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received