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LAKE RIDGE TERRACE BLK 8 LT 5
*ww.-R&ta.� n, +trFarrt+4`�4F?°"� �05I 3�� 25 GRE;"- I ANCHORAGE AREA BOr` 'GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSALSYSTEM NAME JEVt,ZY R�Nr.1Z MAILING ADDRESS I?r A 9(5x 075-A WOrredk PHONE SV4-''PKI LOCATION tAkG tD(aE livig LEGAL DESCRIPTION 407 S' 19kcK 8 tAme(p&E TeiewISE SEPTIC TANK: UL-17gjY& DISTANCE NUMBER OF FROM WELL MANUFACTURER 1511'74tic !�TMe MATERIAL (�Fleetr COMPARTMENTS 2 - INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /000 GALLONS. SEEPAGE PIT: NUMBER OF PITS �. DIAMETER � OR WIDTH V, LENGTH U! DEPTH T LINING MATERIAL /, �RR1/EL CRIB SIZE: DIAMETER ' � DEPTH 9' DISTANCE FROM: WELL pp TOTAL EFFECTIVE rr��-��(( BUILDING FOUNDATION_, NEAREST LOT LINE O� ABSORPTION AREA (WALL AREA). SQ. FT. ADDITIONAL ABSORPTION WELL: Ver tv smle Qf 11"'e WGta yee k0L, TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION -,LOT LINE CESSPOOL OTHERSOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: ele, WOV s PIPE MATERIAL: co .JAI LOT SLOPE: REMARKS: DEPTH NEAREST SEPTIC SEWER LINE -,TANK _ REMA DISTANCE FROM: SEEPAGE SYSTEM _ I GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT PERMIT NO. NAME OF APPLICANT Delay eetj iv lap, MAILING ADDRESS `�k `• p"x 11, 5-(1 '" �HONEj�a�r% INSTALLATION LOCATION 6AKG-l2/AGE !D .1 LEGAL DESCRIPTION Lam -57 S4jk !9�� µ�"` l'eypace INSTALLATION OF: SEPTIC TANK ✓ SEEPAGE PIT DRAIN FIELD , OTHER �. /i 1 a. • � J 'T f TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH — TO BE INSTALLED BY •" "p: ✓t/✓U✓•J r -•• i SOIL TEST RESULTS 7W NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED 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 _ r SEEPAGE AREA SIZE ^` I �` • / TYPE 4- owc&/e MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT Z,p r ' SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT 2,®, TO NEAREST LOT LINE. DRAIN FIELD DRAIN FIELD I f WELL TO SEPTIC TANK /®i/ SEEPAGE PIT /"" —. DRAIN FIELD WATER MAIN TO SEPTIC TANK ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD SEPTIC TANK, //tv SEEPAGE PITO, DRAIN FIELD TO RIVER, LAKE, STREAM. CAST (RAND 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. G.A.A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT I 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. DATE APPLICANT'S SIGNATURE GREAT[ -R ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVTRONMFNTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 v Case 11 Performed Forj os j-e-wz\P— Dated Performed Legal Description: l.ot _j�Block2' Subdivision J, oc This Form Reports Soils L.og_ Percolation Test_' — Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 2------ 3- 4- 5—. ----- 3- 4- 5—. 13- 14— Was Ground Water Encountered?_/7,�2—_ If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H2O Net Drop Percolation Rate Minute Proposed Installation: Seepage Pi,t— Drain Field Depth of Inlet Depth c- Bottom o-f—Pit or Trencfi '— COMMENTS�_.��/^e it Test Performed BY Q ���y_' r Date Certified BY: Date: WATER WELL LOG pis n" FOSS DRILLING mD 1336 Ingra Street Anchorage, Alaska 99501 WELL OWNER e.r USE OF WELL ttb Vim o LOCATION Ar P �/ P rvr t.-, gP , SIZE OF CASING LDEPTH OF HOLEJ_V ,FT. CASED TO % 9 /� FT. STATIC WATER LEVEL.j. FT. YIELD.�GAL.PER.MIN. WITH FEET OF DRAWDOWN. REMARKS Y DATE COMPLETED - f - 9,4' PUMP TO BE SET AT Ern ".3 p:�T �Oto�b �Jc�-y Swr, �l a� ���.✓.vel ��/cvG� .5�� . ic)toi 0-)1LL Al ���, d dr UA-4�) P�e.v to 7p ('Jr��i'Sc��r, bt) G-wyeJ Lo .toy sw�d G�wvJ 1j���'�G'rQ,v� P ey /(15Y't�-✓PSI llito4LLb -Sell, �,� �ra���J l� ✓��la�' W u��r —to_ —to_ to_ to_ _t o_ —to— t 0— to_ —t to� to_ -'' TONY KNOWLES, GOVERNOR i' DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET Telephone: (907) 269-7696 ANCHORAGE, AK 99501 Fax: (907) 269-7650 http://www.state.ak.us/dee/home/htm March 30, 2002 Dee High, P.E.. DHI Consulting Engineers 800 E. Dimond Blvd., Suite 3-545 Anchorage; Alaska 99515 Subject: Lots 4, 5, and 6A, Block 8, Lake Ridge Terrace Subdivision; Wastewater Disposal System Waiver Request, ADEC Project Number 0121 -WW -241-822; Review Dear Mr. High: I have completed my review of the submitted information and the Department's file on the above -reference facility in regards to the requested separation distance waivers. Based on this review, I believe that. the requested waivers are reasonable. Due to the existing soil types, low nitrate levels; lack of bacteria, the great depth of the source wells in the area, changes in State regulations that impact the requested separation distances, and all the information that has been collected for similar separation distance waivers in this area, the requested waivers appear to be reasonable. Therefore, in accordance with the Wastewater Disposal Regulations [18 AAC 72], the following waivers are granted: • The horizontal separation distance between the Class C public water system source well and the complete wastewater disposal system located on Lot 5, Block 8, Lake Ridge Terrace Subdivision serving a duplex has been waived from 150 feet to 98 feet. The Department has no objection to the following waivers under 18 AAC 72, Wastewater Disposal Regulations: The horizontal separation distance between the private water system source well located on Lot 6A, Block 8, Lake Ridge Terrace Subdivision and the septic tank located on Lot 5, Block 8, Lake Ridge Terrace Subdivision from 100 feet to 98 feet. The horizontal separation distance between the private water system source well located on Lot 6A, Block 8, Lake Ridge Terrace Subdivision and the soil absorption system located on Lot 5, Block 8, Lake Ridge Terrace Subdivision from 100 feet to 82 feet. The horizontal separation distance between the private water system source well located on Lot 4, Block 8, Lake Ridge Terrace Subdivision and the septic tank located on Lot 5, Block 8, Lake Ridge Terrace Subdivision from 100 feet to 98 feet. Dee High Page 2 03/30/02 The above noted distances were taken from your submittal. If the proposed wastewater disposal system located on Lot 5, Block 8, Lake Ridge Terrace Subdivision fails or needs to be upgraded, this waiver becomes invalid. If the new system fails or needs to be upgraded, additional treatment to the waste stream will be required. With the change in both in the State Drinking Water and Wastewater Disposal Regulations, it is hard to determine if the water system serving Lot 5, Block 8, Lake Ridge Terrace Subdivision is truly a Class C public water system. Due to all the concern over separation distances, I issued the requested separation distance waivers as if the existing water system is a Class C public water system. As a result, the submitted Class C public water system registration form will be processed in the same manner. The enclosed copy of the signed Class C public water system registration form constitutes final operation approval of the existing public water system. The Public Water System Identification Number assigned to this public water system is 218658. Please make sure that this number is placed on all water test requests sent to an approve water testing lab. The use of this number will ensure that the test results will be properly credited to this public water system. I recommend yearly testing for total coliform bacteria and nitrates. These waivers and approvals do not imply the granting of any additional authorizations, nor obligate any local, state, or federal regulatory body to grant required authorizations. Thank you for your cooperation with this office. If you have any questions, please do not hesitate to contact me. Z i� Keven K Kleweno, P.E. Environmental Engineer Enclosures: As Noted cc: Jim Cross, P.E., MOA, w/o Enc. 02-12-2000 02:42PM DHi nsulting Engineers "1? 344 138E P.02 STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION INVENTORY AND SOURCE REGISTRATION FORM FOR CLASS C PUBLIC NATER SYSTEM A. 1. Public Water System Name and Location: Legal description of property: LL::; �5 1k, t. J LAres ,CrO: f Tcier��ry Number of people served daily: .5 f3cAsl,4 )p, 111-IV2 M of service connections: c>lr v Water Svstem Owner: Owner Phone: I- 1/07-- .94(3 - T31, ' A. 2. Regytired Check List: 515.00 registration fee as required by 18 AAC $0. 1910, 'Results of nitrate and coliform water samples do not exceed the MCL set at 18 AAC 80300, (attach reports from certified laboratory) Source water protection requirements of 18 AAC 80.015 have been met. (see section 8. page 2 for details) Minimum separation distance requirements of 18 AAC 80.020 have been met. �-�. (see section B. page 2 for details) U Cross -connection provisions of 18 AAC 80.025 have been rnet (see section B. page 2 for details) A. 3. Public Water System Source: (circle yes� r. no) YES (`9) Well depth is less than 30 feet to the first opening for water collection. NO Well is located less than 50 horizontal feet to a surface water source. YES Source uses an infiltration gallery, spring, rain catchment, or surface water. YES NO Source requires treatment to matt an MCL set at 18 AAC 80.300. If answer YES to any of the above Public Water System Source, then complete section C. on page 1 For Department Use Only This water system is hereby granted department approval to operate. The following public water system identification numb is being assigned to t is ublic water system: BY TITLE DATE ADEC Staff Signature rev 10/99) Page I STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE FOR DOMESTIC WASTEWATER DISPOSAL SYSTEMS ADEC # 0/?-) - W WJ- a-+1-922 A. APPROVAL TO CONSTRUCT t, o'P s, f3 LOCK. B L A)CE R 1 DG E JIE kRACE Plans for the construction ormodification of Aid 6tJ—'9LTE 1,h45TEa1,4TEt2_ EPLAGEME►J' �e A f} ! l ON1 S EP7t 1 G' '�pNK ,4 I3 5 012P'jtLonl F IEL. b PE t2 5u'D'-`domesnc wastewater disposal system located in L14�� p� Alaska, submitted in accordance with 18 AAC 72.210 by p NZ Gotv5UL7`/uG qtr tuEERS SEE iilGt{ E' have been reviewed and are 1. 5EPtP1G TANK NACED 9!` FRoM 4.o-r6km ❑ approved. el)t-R. too' FRoa'l 4:62`6Aw1 J= tCLD PLACED 85'�RdM e.oCloAwtLL1. © conditionally approved (see attached conditions). 2` ovEt2 too' FROM I.101`5" WELL BY .E DATE If construction has not started within two years of the approval date, this certificate is void and new pians and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order number or descriptive reference) C. APPROVAL TO OPERATE Approved by Date The "APPROVAL TO OPERATE" section must be completed and signed by the Department before this system is made available for use. I. The construction of the VIE L ` o 75zMtx edomestic wastewater disposal system was completed on 2 (date). The system is hereby granted interim approval to operate for 90 days following the completion date. DATE As-built/record drawings, submitted to the Department, or an inspection by the Department, has confirmed that the domestic wastewater disposal system was constructed in substantial conformance with the approved plans. The system is hereby granted final A prov al to ope y` p \J 7S►,/ / t BY ' .� / mTI.E DAT ,- c� 31av/a5z (Rev 4/97) Distribution: 1. White -Engineer (Complete Section C) 2. Yellow -System File (Complete Section C) 3. Pink -Engineer Muni/Borough (Complete Section 4. Goldenrod-Muni/Bomugh (Complete Section Q