HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 11 LT 6Lake Ridge Terrace Block I I Lot 6 #051-323-31 ® DOC CO dba BILL S. COLE LLIVAN WATER WELLS ell" P.O. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: Peter Morris ADDRESS: 14409 Don Circle Eagle River, AK 99577 LEGAL DESCRIPTION Lake Ridge Terrace Block 11 Lot 6 DATE: 3-17-20 PERMIT NUMBER: OSP201039 DATE OF ISSUE: 3-10-20 TAX IDENTIFICATION NUMBER 05132331000 Is well located at approved permit location: ®Yes ❑No Method of Drilling: ®air rotary Elcable tool Depth of Well: 400' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 64 feet Liner type 340' of 4.5" PVC Static Water Level: 14 feet Recovery Rate 49 ® gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end ®open hole Screened Start feet Stopped El Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Recovery Rate is after hvdro frac. Bore Hole Data Depth From To 0 2 2 4 4 13 13 17 17 36 36 88 88 400 Casing Stickup Overburden Silty Sand & Gravel Wet Sand & Gravel Hardpan Bedrock Soft Bedrock Gray w/ Sporadic Fractures & Soft Lenses Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP201039 Date of Issue 3-10-20 Parcel Identification Number: 05132331000 Legal Description Property Owner Name & Address Lake Ridge Terrace Block 11 Lot 6 Peter Morris Pump Installation Date: 4-9-20 Pump Intake Depth Below Top of Well Casing: 352 feet Pump manufacturer’s Name: F&W Pump Model: 4F07G10305 Pump Size: 1 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Pomraning Excavation Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Merrill Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Work Type: Well Upgrade Tax Code Number: 05132331000 Site Legal Address: LAKE RIDGE TERRACE BLK 11 LT 6 G:0553 Site Mailing Address: 14409 DON CIR, Eagle River Owner: MORRIS PETER W Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Expiration Date: Lot Size in Sq Ft: Total Bedrooms: �»enC f- DeI)itrtnient 3/10/2020 3/10/2021 49291 Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B� Issued By: Date: Date: 3 MUNICIPALITY OF ANCHORAGE F On -Site Water & Wastewater Program \ PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite �N�H OR PGE On -Site Water System Permit Permit Number: OSP201039 Effective Date Work Type: Well Upgrade Tax Code Number: 05132331000 Site Legal Address: LAKE RIDGE TERRACE BLK 11 LT 6 G:0553 Site Mailing Address: 14409 DON CIR, Eagle River Owner: MORRIS PETER W Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Expiration Date: Lot Size in Sq Ft: Total Bedrooms: �»enC f- DeI)itrtnient 3/10/2020 3/10/2021 49291 Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B� Issued By: Date: Date: 3 MUNICIPALITY OF ANCHORAGE Development Services Department �'.._ " .j Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel 1. D. 051-323-31 Property owner(s) Peter Morris Day phone Mailing address 14409 Don Circle, Chugiak, AK 99567 Site address 14409 Don Circle, Chugiak Legal description (Sub'd., Block & Lot) Lakeridge Terrace Blk 11 Lot 6 Legal description (Township, Range & Section) Lot Size 49,291 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo AD U) Septic Tank ❑ Upgrade x Duplex ❑ (D) Holding Tank ElRenewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. nature of property owy(OrAf authorized agent) Permit/Rush Fees: A2 L5 Date of Payment: oLq //A0,W Receipt Number: y 0 Permit No. ®SP96 /6--Iq Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc tlpRcTERRq r� ea� ?iI NG 4maw � March 6, 2020 ARC 1 ERRA CONSULTING, INC 20441 Ptarmigan Bld, Eagle River, AK 99577 Office (907) 696-6111, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Well Permit — LAKERIDGE TERRACE BLK 11 LOT 6 The owner has requested we proceed forward to obtain a water well permit to replace the failed well on the subject lot. The proposed upgrade will serve the existing 3 -bedroom house. While the existing well does produce some water it will be decommissioned per current MOA code. There is currently 1000 gallons of water storage available in the house. The adjacent lots are developed and are served by private wellsand septics. There is no surface water within 100' of the proposed well. The septic leachfield on property did pass the adequacy testing during our inspection. The existing septic systems will be outside the protective well radius. We do not expect there to be any adverse effect on adjacent lots by the development of this well. If you have any questions, please contact me at 696-6111 /FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. Duf Attachments: On -Site Sewer Application Wastewater Absorption System Details/ Site Plan 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 PROPOSED WELL DETAILS/SITE PLAN LAKE RIDGE TERRACE BLOCK 11 LOT 6 / NO CONCERNS 9039130" 30857 \\ � N7 \ I PROPOSED NEW F _ _ _ 100' WELL RADIUS WELL EXISTING WELL TO BE I PER CODE SIGNED I N � I rn ` 1 \ W \ a �� o \ 0 / o LU 7171 Z_ P-549 ti-_Qt_nn OF * 4 TH ICMfNM M. s 1 CE -7 18 W� / 10, DRIVEWAY 327.59 PID# 051-323-31 0 EXISTING SEPTIC AREA SCALE: 1" — 40�/ 1. DECOMMISSION EXISTING WELL PER CODE. 2. INSTALL NEW WELL PER CODE. 3. CONTRACTOR WILL ENSURE ALL SEPERATIONS TO ADJACENT. WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... NOTES ALL LOCATIONS ARE ESTIMATES AND MUST BE VERIFIED BY CONTRACTOR. PREPARED FOR: PETER MORRIS 14409 DON CIR. EAGLE RIVER, AK (907)-382-2082 FIELD BOOKS COMPUTED: BOUNDARY. N A DRAW KSD STAKING: N A CHECKED: KMD ASSUILT: _ DATE: 3/6 DWG. FILE GRID: NW05: AGAD FILE: FILE ''DB N0'' 19090 E w 0 N SCALE: NTS On -Site Water System Permit 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 Permit Number: OSP151253 Tax Code Number: 05132331000 Work Type: Well Initial Permit Effective Dates: July 29, 2015 to July 28, 2016 Design Engineer: Subdivision: LAKE RIDGE TERRACE Site Legal Address: LAKE RIDGE TERRACE BILK 11 LT 6 G:0553 Owner/Address: WATSON NICKOLAS T & CHRISTINA J 14409 DON CIRCLE EAGLE RIVER AK 995770000 Site Mailing Address: 14409 DON CIR, Eagle River Lot Size in Sq Ft: 49291 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Privy N Private Well Y 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. Special Provisions: The proposed storage tanks shall be approved by the National Sanitation Foundation (NSF). Special Provisions: A letter from the licensed plumber shall be submitted stating the storage tank(s) were installed in accordance with the code. Received Issued By BY Date: Date: "/ �J T Community Development Department Development Services Division 6 Can -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051 - 323- 31 Property owner(s) %Il,°d�IS±eh j 77vilCe %lrsdlt > Day phone1�CY` Mailing address Site address Legal description (Sub`d., Block & Lot) Legal description (Township, Range & Section) N 4t1 `�ee1 d Ct i(�N�Its, ! G 3, /V� KR Lot Size l Sq. Ft. Number of Bedrooms_ APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (@ all that apply) Absorption Field ❑ Initial Single Family (SF) (wlwo ADU) Septic Tank ❑ Upgrade ❑ Duplex (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings Privy [] (SF and/or D) Private Well ❑ Water Storage 0 THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information Is correct. I further certify that this is in accordance with applicable Municipal Codes. lS/ HOME Permit/Rush Fees: l�J �I Date of Payment: CI Receipt Number: lk ISO6�'s Permit No. Ofa 151253 Permit App_-'.: Waiver Fees: Date of Payment: Receipt Number: Waiver No. S'lJ194 ' Municipality of Anchorage MAY 16 ZQ14 Community Development Department Page 1 of 2 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 141089 PID Number: 051 —323-31 ❑ New ® Upgrade "pTQ1 NICK WATSON ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ound Address: 14409 DON CIRCLE, EAGLE RIVER, AK, 99577 ❑ Other Phone: No. of Bedrooms: Soll Rating: Total Depth from mol grade: (910) 409-3505 3 GPD/Sq. Fl. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gra depth beneath pipe: F Ft. Subdivision: Block: Lot: FII added above original grade: Gravel length: LAKE RIDGE TERRACE 11 6 Ft. Ft. Township: Range: Section: Grovel width: Beft Number of linea: Distance between linea: Ft. Ft. SEPARATION DISTANCES Tolol obs on area: Number of trenches: Dist. between trenches: T° Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Linea Sa. Fl. Fl. Well 100'+ — — — 25'+ TANK ® Septic ❑S.T.E.P. OHolding ❑Other Manufacturer: Copocity: Surface water 100'+ — — — ANCHORAGE TANK 1250 cal, Lot Line s'+ — — — N/A Material: - Number of . compartments: STEEL 2 Foundation 5'+ — — — LIFT STATION Curtain Drain NONE KNOWN Manufacturer: C Ry Gal. 'Pump on' level at: "Pump off I High water alarm at: Remarks: OLD TANK WAS REMOVED AND DISPOSED OF OFFSITE Pump Maka & Electrical Inspections performed by: PIPE MATERIAL House to tank F628 Tank to F628 drainfield Installer Drainfield — CO/MT F628 SCHUETTER TRUCKING LTD. Inspector GEG, Ltd. BENCHMARK (Assumed elevation) Ft. Inspection100.00 Location and Description: Dates: 1 st 5/6/2014 2nd — 3rd — 4th — BOTTOM OF TRIM, NEAR SEWER LINE ENGINEER'S S L Community Development Department Approval oo�o' 4 o oa OF �p Date: Conditional approval: .......... ............. 0 oo.�.... r.....G...ess...� �4p4CE -79 3 �p e^e'.,g�43�Of'�cad0 V �44a Approved: Dater professio°o ��0�0p0o TOP OF TANK AT INLET= 92.07 INVERT OF BUNG AT INLET = 91.39 A—T B DRAWN BY: LAKE RIDGE TERRACE SID; BLOCK 11, LOT 6 Deli 23.21 16.51 AS -BUILT DRAWING OF TANK REPLACEMENT / DBL2 23.72 17.30 ST1 27.14 15.13 ST2 34.94 10.14 / DBL3 37.71 13.11 DBL4 38.02 12.83 AS -BUILT DRAWING ST1 FINAL GRADE = 99.28-99.52 ST2 NEW 1250 GALLON SEPTIC TANK EXISTING 3 BEDROOM HOUSE A 0 0 ° ST1 TOP OF TANK AT OUTLET = 92.08 INVERT OF BUNG AT OUTLET = 91.31 D IO $ m o px I m� I oy T I I IT, y I w A0 I w IT O w I I I I b — NEW 1250 GALLON I N BI ST2 SEPTIC TANK I 11 ° j I OBL3 I DBL4 i II 1 , , I I I , EXISTING DRAINj_U_R_ _____________________J I I I I 1 I I I I I I I ¢tau rroca�°� lS f1SruM� I I I I I 1 1 I I I GARNESS ENGINEERING GROUP, Ltd - CIVIL & ENVIRONMENTAL ENGINEERS UT01 E.TUWRRMD. SUITE 101-ANGg E.AI(9007-PWNE(907 337$1"'FM(WO 335 R<B-WEBSITE: xwx.genwungm�Sng.fvn 7REPARED FOR: - PHONE NUMBER: PAGE NUMBER: NICK WATSON 1 910-409-3505 2 OF 2 AL DESCRIPTION: DRAWN BY: LAKE RIDGE TERRACE SID; BLOCK 11, LOT 6 A.J.G. E OF WORK: DATE: AS -BUILT DRAWING OF TANK REPLACEMENT 5/8/2014 PARCEL ID NUMBER: 051-323-31 2a 0 On -Site Wastewater Disposal System Permit 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 Permit Number: OSP141089 Tax Code Number: 05132331000 Work Type: Septic Upgrade Permit Effective Dates: April 25, 2014 to April 25, 2015 Design Engineer: P did l.__.._...__._..._ _.,.. Garnass Eng. Subdivision: LAKE RIDGE TERRACE Site Legal Address: LAKE RIDGE TERRACE BILK 11 LT 6 G:0553 Owner/Address: WATSON NICKOLAS T& CHRISTINA J 14409 DON CIRCLE EAGLE RIVER AK 995770000 Site Mailing Address: 14409 DON CIR, Eagle River This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 49291 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 BI Issued By: MUNICIPALITY OF ANCHORAGE . (TUBI Community Development Department Phone: 90A�-Z9.04 Development Services Fax: 9ft"11917 On -Site Water & Wastewater Program ` Mayor Dan Sullivan On -Site Sewer/Well Permit Application �.cPrr�c'F.rte�r— For A Single Family Dwelling Parcel I.D. 051-323-31 Property owner(s) NICK WATSON Day phone 910-409-3505 Mailing address 14409 DON CIRCLE *EAGLE RIVER, AK 99577 Site address 14409 DON CIRCLE *EAGLE RIVER, AK 99577 Legal description (Sub'd, Block & Lot) LAKE RIDGE TERRACE; BLOCK 11 LOT 6 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (P� all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Upgrade ® (w/wo ADU) Septic Tank ® Renewal ❑ Duplex (D) ❑ Holding Tank F-1 MultipleDwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: 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: 0 215 Waiver Fees: Date of Payment: �O/Af Date of Payment: Receipt Number:/SC7 Permit No. 6 S OaiwB q Receipt Number: Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS April 21, 2014 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 Ref. Proposed Septic Tank Upgrade for Lake Ridge Terrace; Block 11, Lot 6 To whom it may concern: The existing three (3) bedroom house on the referenced property is served by a p,ivate well and septic system. Per the owner, the existing septic tank has collapsed causing a sink hole and needs to be upgraded immediately. We are proposing to decommission the existing septic tank per UPC and replace it with a new 1250 gallon septic tank. We are unaware of any adverse impacts this installation may have on adjacent wells or septic systems. Ifyou have us at 337-6179. Thank you for your assistance. EMERGENCY REPLACEMENT 3701 East Tudor Road, Suite 101 `Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.00m G, Ltd. HAS A 8 PAGE PECIFICA ION / LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. f NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH & EAST LOT LINES, AND ALL I WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. I RIMING WITH NO RECORD TANK SHALL NOT BE IP WITHIN ANY EASEME NpTe 16 / LA4:E1i10GE TETACE; BLOCK � \ LOT 3�\ \ I I \ NO CONCERNS \ 0/H POWERLINE ( I 100' WELL RADIUS INSTALL FCOXISTING TAI . BE PUMPED DECOMMISSI( PER UPE(E I I I z \ NWO mx 2 1 1 1 �i • AK STATE LAND SURVEY 2006-3; GOVERNMENT LOT 6, TRACT A NO UTILITIES GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3]01 E. 1000R ROID. 6 " 101 • MCHORAM M 88507 • PHONE 807) 337-6179 • FM (907) 338-3246 * B,EB.SRC xxw.9umewm iwd PREPARED FOR: PHONE NUMBER: I PAGE NUMBER: NICK WATSON 910-409-3505 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: LAKE RIDGE TERRACE; BLOCK 11, LOT 6 PNB TYPE OF WORK: DATE: �I DESIGN FOR SEPTIC TANK UPGRADE ONLY 4/24/14 'To AND FIRE LAKE; LOT 2, TRACT K NO RECORDS )SED 1250 )N SEPTIC TANK 7L DBL C/O'S FIRE LAKE; LOT 3, TRACT B Municipalityof Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage. Alaska 99519-6650 • (907) 343-7904 s Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program spent �, r• n 07 i V n Department * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSP121180 COSA#: Permit#: PID#: 051-323-31 Legal Description: Lake Ridge Terrace, Block 11, Lot 6 Engineer: Garness Engineering Group Applicant: Benjamin & Karen Iris 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 2.0 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. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ 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: Approved by - of Reviewer .............................................................................. Rec#: 05795G Amount: $200.00 Date Paid: 7/9/2012 **** VARIANCE/WAIVER REVIEW **** GARNESS ENGINEERING GROUP , Ltd. _s CONSULTANTS & Gr=MERAL CONTRACTORS. _ v. July 6, 2012 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 iVtON57Q-9 a3,31 abs -3 Ref: Lot Line Waiver Request for Lake Ridge Terrace; Block 11, Lot 6, To whom it may concern: We request that your department issue *-foot lot line waiver from south property line to the existing drainfield. The neighboring property (AK State Land Survey 2006-3 Government Lot 6 Tract A) is state land and is currently occupied by office buildings but indicates that there are no utilities serving the property. With no utilities on the neighboring lot the existing drainfield on Lot 6 has a minimum separation distance of at least 10 feet to any neighboring drainfields. We are unawareof y adverse impacts these waivers would have on adjacent wells or septic systems. If yo ave any questions, please contact us at 337-6179. Thank you for your assistance. / , M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com MUNICIPALITY OF ANCHORAGE Y 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 p r Gt,�L.p( j(j��/��_ PHONE 6277—Oqd NEW ❑UPGRADE MAILING ADDRESS _ tf ^� L4 D. :e Q LEGAL DESCRIPTION '4L. LOCATION NO. OF ¢EDROOMS UY DISTANCE TO: Well �U 1 + Absorptlgn area 19/ Dwelligg l �O PERMIT NO. az W F. Manufacturer ,�j - _ _ _ ✓eYIX�E/L Materi No. ofmpartments rn gallons Liq. ctpa!t U in IF HOMEMADE: Inside length Width Liquid depth JUZ DISTANCE TO: Well Dwelling PERMIT NO. Z a S—F Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well !OU + Fou dayon �g Neare of ane Q PERMI ,C `' C% 361 - _j LL Z P Z w M No. of lines' Length Fyline Total length o n6s Trench widtt ( 3.1 inches Distance between lines O Top of tile to finish grade Q S Material beneath tile / inches Total effective absorption area . Q w C7 Length Width Depth PERMIT NO. a F wa Type of crib Crib diameter Crib depth Total effective absorption area w uj DISTANCE TO: Well Building foundation Nearest lot line J Clas Depth Driller Distance to lot line PERMIT O. ©_. r 5 LU I DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS 'J3v31{ SOIL TEST RATING r e 46R y [� INSTALLER L REMARKS i APPROVED DATE LEGAL t•10�tJ I f= I F='RL_ I T'0 10E r-fNo-="10F�r=o13E DEPARTMENT HEALTH AND ENVIRONMENTAL -"`�OTECTION 025 'l STREET, ANCHORAGE, AK 95-. !1 y 7 / b . . 264-4720 ' 14EL_L_ !1t-.FC.A o_ot-F— I TE �F;L-4 EKE" F"•Imo.F,*f-1 I PERMIT NO. C 780365 ) APPLICANT RICHARD BEMIS 342 E 9TH LOCATION DONS CIRCLE LEGAL L r B 11 LAKE RIDGE TERRACE 'Au LOT SIZE 48200 rUARE �5� TYPE OF SOIL ABSRRSTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR ) THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: bvAA00 , - -is I~D,EF="THI— :3_�' L_E"o_e'T-" <L I �,6 nnL THE LENGTH DIMENSION 15 THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F? F= ID L_o I F=-'. E E-- !S E F=' T i s T""Fes. !E; I 27- F= = - ;2!5 ID 0 F=l L_ L_ ID "S3 PERMIT APPLICANT HAS THE RE`:PONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ._...._,,.._ T Fr -F o� t. � :� 11*,F' = F=" F� o.�. T I o.�o t-dlw t� F=� F� F� F=' �� �.J� I Fes' F= L=ti --• — — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL: OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICTATIONS FIND CONSTRUCTION DIAGRAM'S ARE AVAILABLE TO INSURE PROPER INSTALLATION. F=m EF?M I T UXF= I Fl E'= C1 F= o=: F=MEtEF;' �L - =LN -=A : '_� I CERTIFY THAT 1: I AM FAMILIAR: WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON --SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. r S I GNE L - _ _�____ _---�- ---__ A LICAN'f RICHARD BEMIS ISSUED B4'_ _ ___%-DATE _ �� •. .' N 2onstricad t ion gait eat "Lips fast is wcnds a shousand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For Date Performed�� �$ Leal Description: Lot_je 6lock.Z/ Subdivision L� ��� This Form Renorts Soils Loq—Percolatior, Test_ neoth Feet Soil Characteristics 2 =-- 4® 6® ro 6V 10- 1- 18 204 Was Ground Water Encountered?— If Yes, At what Depth? Readinq I Date I Gross Time Percolation Rate M nuts Prnrosed Insta atlon: Seenaae Pit Drain Field Deoth of Inlet Dent o ottom df Pit Or rend VmVENTS: ,/f ��evr� /�i��� / r��4- --- ata Certified B — Test Performed By D y', Date: z by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694-2588 OWNER OF LAND i P /- oaf) % / 7 / DEPTH OF WELL 1110 e ADDRESS STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION_ ( v 16 _' R 1 1: DRAW DOWN FT. DATE, - Started T �� ✓�" Ended �jj GALS. PER HR j rj PERMIT NUMBER f �' KIND OF CASING KIND OF FORMATION: From Ft. toFt. From Ft. to Ft. From Ft. to _ Ft. /��.'�tJ From Ft. to Ft. From Ft. to JL 2 Ft. t- f : J '- >> c From Ft. to Ft. 76 From i r Ft. to 5 Ft.=/�r /- �"h�f�����l� From Ft. to Ft From ` > Ft. to Y �- Ft p •<' rt From Ft. to Ft Z`t.v From r, .-- Ft. to Ft. « F �lSc ©ci.. = =. r� F.J From Ft. to Ft. From '._ Ft. to '� Ft. /d ip 9 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. 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. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to - Ft. From Ft. to Ft MISCL. INFORMATION: iiiiii i TT)[T 1T1TlT - �. - Municipality ®f Anchorage FY On -Site Water and Wastewater Program 907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-323-31 Expiration Date: 20 2-(:) 1. GENERAL INFORMATION Complete legal description Lake Ridge Terrace Block 11 Lot 6 Location (site address) 14409 Don Cir. Current Property owner(s) Peter Morris Day phone 907-382-2082 Mailing address Real Estate Agent 14409 Don Cir. Eagle River AK, 99577 2. TYPE OF DWELLING: M Single Family (w/wo ADU) M Duplex F-1 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well M Individual Water Storage Community Class_ Well Public Water System WaiverNariance request for: Received by: 3 Day phone TYPE OF WASTEWATER DISPOSAL: Individual M Holding Tank 0 Community El Public Sewer F1 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5-5p Date of Payment al &Z2120 Receipt Number COSA # (0 6 CV 0 Q?' Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 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 ARCTERRA CONSULTING, INC. Phone 696-6 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date f Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen if OF A I \ encroachments, deficiencies or discrepancies exist. / 49 Ti k 6. DSD SIGNATURE System #1 Approved for bedrooms. ?, KENNE . 7l FUS r 6 System #2 Approved for bedrooms. ' \F E./ 1 0 1 = Disapproved. Conditional approval for bedrooms, with the following stipulations: ttllll(((((fr,. POLI FY NS CEb B tn,. Original Certificate Date: • 2%Z 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 COSA blue sheet 10-10-12.doe X X 12/11/2019 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343- 7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Well Water Advisory Certificate of On-Site Systems Approval # OSC201043 Subdivision: Lake Ridge Terrace, Block: 11, Lot: 6 This well’s productivity was determined to be 0.49 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3-bedroom residence is 0.31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate and may be insufficient to meet your needs. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343- 7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Nitrate Advisory Certificate of On-Site Systems Approval # OSC201043 Subdivision: Lake Ridge Terrace, Block: 11, Lot: 6 A water sample revealed a nitrate concentration of 6.42 milligrams per liter (mg/L). 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. Municipality ®f Anchorage FY On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-323-31 Expiration Date: 20 2-(:) 1. GENERAL INFORMATION Complete legal description Lake Ridge Terrace Block 11 Lot 6 Location (site address) 14409 Don Cir. Current Property owner(s) Peter Morris Day phone 907-382-2082 Mailing address Real Estate Agent 14409 Don Cir. Eagle River AK, 99577 2. TYPE OF DWELLING: M Single Family (w/wo ADU) M Duplex F-1 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well M Individual Water Storage ❑ Community Class_ Well ❑ Public Water System ❑ WaiverNariance request for: Received by: 3 Day phone TYPE OF WASTEWATER DISPOSAL: Individual M Holding Tank 0 Community El Public Sewer F1 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5-5p Date of Payment al &Z2120 Receipt Number COSA # (0 6 CV 0 Q?�' Date: Waiver Fee $ Date of Payment Receipt Number Waiver # ,Distance: 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 ARCTERRA CONSULTING, INC. Phone 696-6 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date f Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen if OF A I \ encroachments, deficiencies or discrepancies exist. / 49 Ti � k � 6. DSD SIGNATURE ............... System #1 Approved for bedrooms. ?, KENNE . 7l FUS ,r 6 System #2 Approved for bedrooms. ' \F� E�./ 1 0�1 = Disapproved. Conditional approval for bedrooms, with the following stipulations: ..ttllll(((((fr�,. POLI FY NS "'= CEb B tn,. Original Certificate Date: �� • 2�%Z� 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 COSA blue sheet 10-10-12.doe Legal Description: COSA Checklist Lake Ridge Terrace Block 11 Lot 6 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 6/2/78 Total depth 100 ft Cased to 35.33 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in Date of flow test for COSA Z'2 2O Static water level at beginning of test S ft. Comments B. TANK DATA Age of tank(s) 5 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 49" Standpipes/foundation cleanout per record drawing Date of pumping j• i j i R D. ABSORPTION FIELD DATA Which system tested (date installed) 8/17/1978 11 ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A - pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 051-323-31 Structure served by this system 1 i Well production at time of testa 9 4 Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes No Coliform bacteria is Negative Nitrate"�mg//2 ❑ Nitrate less than MRL (ND) Arsenic ug/L N Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 12/9/19 /-2.-Z7, Zo 4e1'i Voom ✓6rit.ed 6U Q41,:R'L'n C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 12/9/19 Results Q Pass For 3 bedrooms Fluid depth prior to test 4 in Water added 450 gal New depth 27 in Elapsed time 1200 min 4 Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _ date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Community Sewer Manhole/Cleanout > 100' ® Yes if No ft [o Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ft ft ft ft ft 0 Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' 0 Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' 0 Yes if No Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 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. COSA Checklist yellow sheet ft ft ft ft P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Dea Duffus JOB LOCATION: 14409 Don Circle Eagle River, AK 99577 Flow Test Report Total Depth: 170+' Resting Static: 15' Max draw down: 167' Well Yield: 1.1 GPM Some water was coming in at 20' Date: 12-24-19 DEVELOPMENT SERVICES DEPARTMENT On -Site water and wastewater Section www.muni.org/onsite Well Water Advisory Certificate of On -Site Systems Approval # OSC201043 Subdivision: Lake Ridge Terrace, Block: 11, Lot: 6 907-343-7904 Fax: 343-7997 This well's productivity was determined to be 2 gallons per hour. The minimum well productivity required under (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. t Mailing Atldress P O k',196650" * Anchorage, Alaska 99519 6650 *www muni org -pqnS 9�ej aii:j 00 >1 101 0 z 0'081 AA..00,t7O.00N LL 0 cn y w - C 1-- 00 -a) _j U) 0) m M Z VIM 0 m U) w Tc Q cc I -� Cc �501 0) QC)L 0 0 L.a- C, 0 o 0 U) O Vi 0 E 2 CN as 0) (u a) = r U) -7�: luawase�i Ai!mn,oz U) o U) co 2 'E, Lu C, z .X CD X. < E E > W Z a) o a) U) C: -r- >0 'm o W'& 0 — 0 CL 2 LL 0- 0 - 0:c 0 a) M CL 0 — 2 m LL W r 2 E U� CL 0 > (1) a CCD OC 0 z c -2 a ca 0)'D 0 3: 0) < 8 76 b 'm a N I_- c �11 Cb Q) 7.--. — Z3 LL U) �- Q) S2 P S OL:E-: 0- ' (a 3� 0 a) C: 0 E 0 -0 Li 0)a1 0 - .2 0 o o 0 a 0 N>0 !E 0*6C m (U 2 E 0 -6 :5 E cn C\l asnOH qz� awe's "JOIS T 6 L 0 < �o LL 12 (u 0 >O 'D0 W o (N N 0'6 L Z Iq cu (U 0 Q0 0 ?i -o cu m Q CD (V r-- -ro C) Noop LO 0,9 L LO < 0 Ern < C5 CN -0 (0 O'Lz w m 0 0 CU 0 3: CL Z 46.4 (3 oc C6stor 0 Gatag e co 23 .4 0 - : 1:*a - a) 3: w 0 LO . rl- C'4 00 z00 co co 00 00 LO co 0 000- -C 00 C-4 L, 0 CY) 00 jf > 2 0 co 6 CY) 75 > 00 z O iri co U- ce) z < C) w W�z 6 0 w Z www - U) 0 x -r W kA' < 0 m: C-) i— pyo w 0 C of W cxli�c-- o O,IA L.L 0 z I - U) o !L0 z z w ME J2w ww < w 0 < w o w1=—a. IL CO CO 0 SLC fl4 • Municipality of Anchorage. On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-323-31 Expiration Date: f 1. GENERAL INFORMATION Complete legal description LAKERIDGE TERRACE; BLOCK 11, LOT 6 Location(site address) 14409 DON CIRCLE *EAGLE RIVER 99577 Current Property owner(s) Nick & Christina Watson Day phone 910-409-3506 Mailing address 14409 DON_CIRCLE "EAGLE RIVER 99577 Real Estate Agent Elizabeth MacMullen Day phone 775-1812 2. TYPE OF DWELLING: ® Single Family (w/woADU) ❑ 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 ❑ Waiver/Variance requ s for: N/A LQC'' At" � &440'' Distance: CD Received by. Date: /;L/Icd/ COSA to be cele to the engi er nless otherwise requested by the engineer. _ COSA Fee $ j Waiver Fee $ a) 5r Date of Paymenf/ Date of Payment Receipt Number � (n �J� vl Receipt Number 015190 G COSA# Waiver# 85171 Jc" t (5Z 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 SystemsApproval 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' E. Tudor Road, Suite 101 Anchorage AK, 99507-1259 , Engineer's Printed Name Jeffrey A. Garness Date t I J..1 -7 ij In conducting this evaluation, GEG provided an engineering evaluation of the well and/orseofic •-•---••ts c, coon uraw'ues were measurma to madly Identifiable features." Hiddehdefecorencroachments may exist that were not identified during the evaluation. The . operational life of allwells and septic systemsdepend on a variety of variables.iricludingj'but not limited to. soil conditions: ornund"tpr la,torc nAor:.. ,.n„.,:r,,: guarantee future performance of the systems thereforeGEG makes no warranty (express or g .• ...... g. . �- implied) regarding the future performance of the well or septic system GEG makes no f • ' ,A G ,• ess ,$S -i representation whether an altemative well orseptic system can be installed on the property in the G �c even( either of the current systems fail. The content of this report is for thesole benefit of the ♦ �1.3. persorubarty who. retained GEG.. Reliance upon the information provided in this report by any other ♦♦ ;)- 1. i� Demon or party, including but not limited to subsequent property purchasers, isnot authorized. In ♦ pper�,,,,,,,,__ Short, . GEG disavows any legal duty to anyone other than the person/party who paid for this. report. - •+�'lwf t$$��`P�'��• ittitit 6. DSD S ATURE ���Y 0Fq�C � rr System #1 Approved for bedrooms ON-SITE System #2 Approved for bedrooms � WATER AND Disapproved WASTEWATER 2:= Conditional approval for bedrooms, with the following stlpulAP PROGRAM o �cj By: Original Certificate Date:_1 2—i —15� 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 Septic System Advisory Arsenic Advisory Well Flow Advisory LIZOther CASA blue sheet &i-12.Eoc If more than 1 septic system is on the tot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: LAKERIDGE TERRACE: BLOCK 11, LOT 6 Parcel ID: 051-323-31 A. WELL DATA *CASED TO BEDROCK Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) YES Date completed 6/2/1978 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 100' ft. Cased to *35.33 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 6/2/1978 7/3/2015 Static water level 17 ft. 23 ft. Well production 1.5 g.p.m, **0.08 g.p.m. WATER SAMPLE RESULTS: **1000 GALLONS OF STORAGE PROVIDED - Coliform 0 colonies/100 ml. Nitrate 1.32 mg./L. Collected by Arsenic: ND ug./L. Date of sample: 11/4/15 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments E Date installed 5/6/2014 Cleanouts(Y/N) Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping (o /02-11-157 Pumper w,. +`o^ ✓l Q�r rAGnf C. ABSORPTION FIELD DATA '6ELow Exr irlc cw Date installed 8/17/1978 Soil rating OEd / r.ftbdrrn) 154;; System type TRENCH Length 75 ft. Width 2.66 ft. Gravel below pipe 4 ft. Total .depth * 10.8+ ft. Eff. absorption area 600 ft2 . Monitoring tube YES Depression over field NO Date of adequacy test 6/15/2015 Results (Pass/Fail) PASS For - 3 bedrooms Fluid depth in absorption field before test 38 in. Water added 579 gal. New depth *****On. Elapsed Time: 11473min. Final fluid depth 43 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date ***l INCH ABOVE INVERT ■ D. LIFT STATION Date installed Size in gallons Manhole/Access ffV "Pump on" level at in. "Pump ofr level High water alarm level at in. Cycles tested Meats alarm $ circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots Public sewer manhole/cleanout 100'+ Holding tank 75'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:j/J Building foundation 5'+ Property line 5'+ Absorption field 11,34 Water, main 10'+ Water service line 10'+ Surface water, 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line **2'+ Building foundation ***6' Water main 10'+ Water service line 10,+ Surrace water 100`+ Driveway, parking/vehide storage 10'+ Curlain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *DURING TANK UPGRADE, A LIMITED 5' SECTION WAS EXPOSED AFTER THE TANK, AND NO DRAINFIELD OBSERVED. **OSP121180. - ***SEE ATTACHED WAIVER REQUEST. COMPLIANCE OF NEW WATER STORAGE TANKS AND PUMP WITH UPC & NSF WAS NOT EVALUATED C Rvtt Awo* ` 0 so— G. ENGINEER'S CERTIFICATION ?Ad G iA o (scbued POA 4J0. I certify that I have determined through field inspections and review of Munidpal records that the above systems are In conformance with MOA COSA guidelines In effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Data I11�7rf� (Rev. 11/05) BY GARNESS ENGINEERING S.• Municipality of Anchorage 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 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # osc151645 During a recent COSA on-site inspection and test of the potable water supply well on Block 11, Lot 6 of Lake Ridge Terrace subdivision, the well's productivity was determined to be .08 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .312 gallons per minute. Current well doesn't meet minimum Flow. Water storage has been provided per Code 15.55.070 all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS July 8, 2015 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 Ref: Lakeridge Terrace; Block 11, Lot 6 — Waiver request for drainfield to foundation encroachment To whom it may concern The referenced property is serviced by a well and septic system. An encroachment currently exists from the drainfield to the house addition foundation. The horizontal distance appears to be just over 6'. After discussions with your department, it appears that the most recent building permit was pulled in 2007. It is unknown if the 2007 permit was for the detached garage or the home addition. Regardless, we know that the encroachment has existed for at least 8 -years, and perhaps much longer. We are requesting that your department issue a waiver for a horizontal separation distance of 6' from the foundation to the drainfield. Our justifications are as follows: The encroachment has existed for at least 8 -years. The portion of the foundation encroached upon is a slab on grade living area that is higher in elevation than the drainfield. The encroachment does not compromise the foundation. If you have any questions, please contact Jeff Gayness or Rob Campbell at (907) 337-6179. 3701 E. Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com Municipality of Anchorage r On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I. D. 051-323-31 1. GENERAL INFORMATION Expiration Date: I— �1 — f 3 Complete legal description LAK IDGE TERRACE; BLOCK 11 LOT 6 P Ont Location (site address) 14409 . CIRCLE *EAGLE RIVER, AK 99577 Current Property owner(s) KAREN IRIS Day phone 677-1011 Mailing address 14409 DAWN CIRCLE *EAGLE RIVER, AK 99577 Real Estate Agent AMY MACKEY—HORNAK W/ KELLER WILLIAMS Day phone 830-1294 2. TYPE OF DWELLING: 0 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 On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by:Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ I6 1 Date of Payment 5j13 Receipt Number ��+ o'la 3`lc COSA # o JL RA a k a Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, RE Engineer's Comments: In conducting this evaluation, GEG, LtD. 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 of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational rife 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 control 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 legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. bedrooms. ON-SITE bedrooms, with the following stipulations` Z WATER AND �� rc_X A]ATER System #2 Approved for Disapproved. Conditional approval for 337-6179 Date Original Certificate Date: The W it 0alitf os�Ahchorage 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: COSA Checklist Septic System Advisory Well Flow Advisory (Rev. 111105) Nitrate Advisor i Arsenic Advisory Other s 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: LAKERIDGE TERRACE; BLOCK 11, LOT 6 A. WELL DATA,. *CASED TO BEDROCK Well type PRIVATE If A, B. or C provide PWSID# N/A Date completed 6/2/78 Sanitary seal (YIN) YES Total depth 100 ft. Cased to *35.33 ft. FROM WELL LOG Date of test 6/2/78 Static water level 17 ft. Parcel ID: 051-323-31 Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/27/12 28 ft. Well production 1.5 g.p.m. 1.14 g.p.m, WATER SAMPLE RESULTS: Coliform U colonies/100 ml. Nitrate • 59mg./L. Collected by: GEG. Ltd. Arsenic: d10 ug./L. Date of sample: -5/1113 B. SEPTIC/HOLDING TANK DATA *C/O IN HOUSE PROVIDES ACCESS TO SEPTIC TANK. SEE RECEIPT FROM ONE STOP SERVICES. Tank Type/Material SEPTIC/STEEL Date installed 8/17/78 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) *NO Depression over tank (Y/N) NO High water alarm (Y/N) N/A V Date of pumping 5 3 Pumper 'L 1 S 5� c C. ABSORPTION FIELD DATA *BELOW EXISTING GRAD Date installed 8/17/78 Soil rating (g.p.d./ft`or /bdrm 150 System type TRENCH Length 75 ft. Width 2.66 ft. Gravel below pipe 4 ft. Total depth *11.08 ft. Eff. absorption area 600 ft' Monitoring tube YES Depression over field NO Date of adequacy test **6/20/12 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 45 in. Water added 500 gal. New depth ****59 in. Elapsed Time: 120/899 min. Final fluid depth 55/47 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — QZA"'166'0 fN' 5-11113 T `1� K � 1S Vi' TC J"" wtvicl ,Q.1�Zl Nt OIS 71\ Ubu�e. ��L 1.hv tYk, D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN "Pump on" level at in. "Pump off' level i . High water alarm level Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank N/A 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 N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line **� Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 2' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *PER INSPECTION REPORT **SEE ATTACHED WAIVER REQUEST. G. ENGINEER'S CERTIFICATION 1 certify that l 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 d 3LIJ (Rev. 11/05) Municipality of Anchorage Pp6E 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 Svstem Advisory Certificate of On -Site Systems Approval # 131212 During a recent adequacy test on the septic system for Block 11, Lot 6 of Lake Ridge Terrace subdivision, 45 inches of standing water was observed in the absorption field. This indicates that approximately 93% 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 SCALE: Registered; Land Snry _ 8. EaBIe Riper, MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES y Division of Environmental Services On -Site Services Section, P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # HAA # GENERAL INFORMATION Complete legal description Lot 6; Block 11; Lake Ridge Tenn.ace Subdivision Location (site address or directions) 14409 Don Cikete LO L_2LL2 Individual on-site Holding tank Community on-site Public sewer - NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone Address 17034 Eagle River Loop Road Na. 204 age Iver, as a Engineer's signature Date 6. DHHS SIGNATURE 4— Approved for bedrooms. Disapproved. Conditional approval for ER J jjK No. 5 PROFESSIONP� bedrooms, with the following stipulations: Additional Comments Note: The well for this property meets existing State and Municipal Codes. There are nitrates present. It that a periodic testing be performed to insure the wells contin 4c_ suitabihty�Nitrate concentration is 6.1 mg/l. EPA The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Beck MOA H21 Municipality of Anchorage Department of Health & Human Services _ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: La'r 1_9 (�LItL L ( LP!1k, 12to49�___ Parcel LD Tom. slb A. WELL DATA Well type VLNIAr[Y., If A, B, or C, attach ADEC letter. ADEC water system number Log present JS�'N) Date completed Lo '' 6 Driller ` L Total o o depth t p Cased to 5.9- Casing height lZ�+ Sanitary seal &N) Date of test Static water level Well flow Pump level Wires properly protected O/N) FROM WELL LOG ! t qa. p laPk� g-p-tx'• � IZ— AT INSPECTION s�tl�R nti GI -23 %l Z MdoiJa�Mr: �t1S -1'A:K-f�,.l, rl bj'r� acLoosTickc. L co( S3 : a ,PpeR�DP�& j D®�E�pv"Pfil aF • IL 2661 � Z d3S SEPARATION DISTANCES FROM WELL TO: NOISIAIa S3DIA83S1V1N3WNO-dIAl3 3EJV80HDNV AO Al11VdIDINnV Septic/holding tank on lot eco ��. ; Ort -adjacent lots 1 bo k 4 - Absorption Absorption field on lot 1 va k ; On adjacent lots t L)b `} Public sewer main �b Public sewer manhole/cleanout �p Sewer service line ZS t Petroleum tank 2.5- WATER sWATER SAMPLE RESULTS: 1 b C1.� ,00 ►� i. Coliform Nitrate 10•, �• Other bacteria ►-l.o vld�. Date of sample: 9 r 14 -c1 ?.— Collected by: ' S & S ENGINEERING' B. SEPTIC/HOLDING TANK DATA 17034 Eagle River Loop Road No.204 gagle RIVer, Alaska 99577 Date installed 1`11 $ Tank size i2sa Compartments Z Cleanouts®/N) Foundation cleanout (ya Depression (Y,6) High water alarm (Y& �Ii Alarm tested (Y/N) "J)A• Date of pumping l7 SZ Pumper -VA, (Fss POOL SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(s) on lot oc> k On adjacent lots To property line Iy t Absorption field S t� Surface water/drainage 1 v o t Foundation t4 - Water main/service line 10 72-026 (Rev. 7/91) Front - CONTINUEDON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical "Pump on" level at Manufacturer Manhole/Access (Y/N) SEPAR&T401VDISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "dump off' level at Cycles tested Surface water _ Date installed I 1 Soil rating jso `� ��- System type __1 -K4xAa _ Length _15 Width 32� Gravel thickness Total depth a Total absorption area LDO Cleanouts present&N) Depression over field (Y16) nJ Date of adequacy test Results ail) RP65 for bedrooms Peroxide treatment (past 12 months) (Y/N—b /4°�"-3, k 1) krinl If yes, give date _ JlAe >� o,JL.-q A-" � r�,c:�v, & -ri424_,,f' c32. A01001z,� SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot l u (J On adjacent lots t na `r Property line To building foundation On adjacent lots '3Ot}- To existing or abandoned system on lot Cutbank t` `a- Water main/service line_ Surface water lOo t� Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION lock I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on t�q date of this inspection. ,a S 8: S ENGINEERING 77034 Engle River (Loop Road No. 2094 Signature Eat Engineer's Name W087:S�51 Date J G' No. a ifi 011 r��ibn6 HAA Fee $ Date of Payment 1-1 Z_C) Receipt Number4 Waiver Fee: $ Date of Payment Receipt Number F'1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date June 29 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) T ni- h Rl nnk 11 T akeri dge Terrace T1 FN RJW ScC 31 Location (address or directions) (b) Applicant Name Richard Bemis Telephone: Home 688-395 Business A'A Applicant Address S R B 363 Ragl e River, Alaska 99977 (c) Applicant is (check one): Lending Institution ®; Owner/builder ❑ ;Buyer ❑ ; Other ❑ (explain); (d) Lending Institution of askg Ccint inental Rank Telephone Address 1016 W Northern Lights Anchorage Alaska 99508 (e) Real Estate Company and Agent N)f Address Telephone (f) Mail the HAA to the following address: Pi ckufLy engineer 2. TYPE OF RESIDENCE Single-Familyi] Multi -Family❑ Other Number of Bedrooms 2 3. WATER SUPPLY Individual Well ® Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, D.,. A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation ofthis Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone EAGLE RIVER ENGINEERING SERVICES Address Date 694-5195 6. DHEP AFPROVAL l ' Approved for (_ k% - bedrooms by Date Approved Disapproved Conditional Terms of Conditional Approval dhep CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOP., HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANCHORAGHECKLIST - FEBRUARY 1984 DEPT. OF HEALTH & 264-4720 ENVIRONMENTAL PROTECTION / Legal Description: L N 2998 TSL tv St? c, - A. WELL DATA RECEIVED Well Classification / vim' �!' If A, B, C, D.E.C. Approved (Y/N) �i Well Log Present (Y/N) r Date Completed d 7� Yield G /Sp >er(ele Total Depth /aa � Cased to 3� �� �> Depth of Grouting tiles Static Water Level c�Z % ✓� �� > Pump Set At 7U Casing Height Above Ground Sanitary Seal on Casing (Y/N) f Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ; On Adjoining Lots }l6 To Nearest Edge of Absorption Field on Lot rj`' > ; On Adjoining Lots To Nearest Public Sewer Line ��L To Nearest Public Sewer Cleanout/Manhole n14 To Nearest Sewer Service Line on Lot �� r Water Sample Collected by 4�..k le,`g4 Date Vzh�e Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed �5 %� w Size /-2 Sri Gg No. of Compartments Standpipes (Y/N) y Air -tight Caps (Y/N) i Foundation Cleanout (Y/N) y Depression over Tank (Y/N) ') Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: i To Water -Supply Well llGU To Building Foundation 0 To Disposal Field To Property Line 7LJ.)' To Water Main/Service Line Course Comments Page 1 of 2 1. „�.,,,,QA, To Stream, Pond, Lake, or Major Drainage Z "40M Xi"ve_ Codi s'-1wc rV 9wi7h9 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field 3 Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field X�_ Depth of Field r ✓Gravel Bed Thickness �✓ C� DO r Standpipes Present (Y/N) IU Date of Last Adequacy Test �.fis�z 7�^e, �dSar6}ivy A0 A, ]Th ;2 e�ror Separation Distance from Absorption Field: To Water -Supply Well ��yy To Building Foundation Lot le -4 To Water Main/Service Line /o' -1,161 To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments To Property Line 1a / To Existing or Abandoned System on On Adjoining Lots /-Y" To Cutbank (if present) y0-4 /ov � Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I �have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date �Z, Company's ` MOA No. Receipt No. Date of Payment Amount: $ (� ( Engineer's Seal Eagle River Engineering Services Page 2 of 2 P. 0. Box 773294 Eagle River, AK 99577 694-.5195 72-026 (11/64) -(J V(, ! C'> t U e Nip X17 JFT Ole r,)iT MUNICIPALITY OF ANCHORAGE MUNILIML11Y 01 - DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION • OCT 4 1978 ENVIRONMENTAL ENGINEERING DIVISION NUMBER OF BEDROOMS Telephone 264-4720 R E C E I V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPE TYOWNER 9�3�Three ❑ Six PHONE INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled MAILING ADDRESS e since June 1975. For wells drilled prior to that date, give well '3�a a depth (attach log if available.) — ` PROPERTY RESIDENT (If different from above) **If PHONE 2. BUYER _ PHONE MAILING ADDRESS by this Department. 3. LENDING INSTITUTION PHONE / �y �✓/r"C� L� 0��� " �I of aC MAILING ADDRESS ` &©/ � r 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION _ STREET LOCATIOIT S �;czezey 6. TYPE OFF RESIDENCE NUMBER OF BEDROOMS KT'SINGLE FAMILY El One ❑ Four E] Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY 9�3�Three ❑ Six 7. WATER SUP Y INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) — ` 8. SEWAGE DISPOSAL SYSTEM **If Com` INDIVIDUAL/ON-SITE** individual/on-site, give installation date. If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. /2-uluij/RS) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE _ INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER ^, - TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Rol di ng Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR _BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE `f •n' BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78) � 1 APPLIC `NT FILLS OUT UPPER HAI ONLY PParty Owner � ,>7�, - Phone ailing Address Zip Code Buyer 1 Address Zip Code Lending Institution %" f A -- - - Phone Address Zip Code Realty Co. & Agent Phone Address - Zip Code Date Legal Description,.;�g <rs= Inspector Street Location Type of Residence - - K Single Family I ❑ Multiple Family No. of Bedrooms ❑ Other Inspector Water Supply �� _ -ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. IKIndividual 11 \ r_-,,. _. Community t��.� \ - For wells drilled prior to that date, give well depth (attach log if available). El Public Utility \, - - Sewer Disposal - -- -- 0 Individual 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. Time Time Time Time I Date Date Date Date r�r� Inspector Inspector Inspector Inspector Field Notes: gad • ��z� � �( "�� HEM � E M AUG 3 1983 ( I) APPROVED BEDROOMS `CONDITIONS OF APPROVA ,�, , •: rfaT^^ilCft" t:,:i;,,.: ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE r BY: v`✓ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received - Septic Tank Size a O iCj - D Well to Tank )bp f -0 o- r, -U 010A octo7ner 6, 1978 8 YUchard Benin 342 East 9th} sivcnue Anahcrage, Alaska 59301 Subject: Lot 6 IiIr5ck 11 Lage Ric,-,qe Terrace vUbd'i.vi.Si0n. This departMent can not send and approval to the l rldi.lag agency until the well Zeal is tight "d so that it is -4ater tight and the cie;ore ssion arotuid the well casing needs to be filled se that the grOu e d level s2nPcs 0-vla' rev, the wel3, caoirm h ? c} need to s?k ftr this i co;--, tthis an ins- ect-3.cn, Of thc w0ll-W?grado' there are ally fust% -:r �zcrestiocjls, pleane contact this office at 264-47"In• sincerely, Tle Bert C, Prat '.r R.S. Associate Special-iz� %[tendon $ Larry Carpap tre l Pouch 7-0-15 ! q� 'tn