HomeMy WebLinkAboutLAKE O THE HILLS EAST BLK 1 LT 1Lake O' The Hills East Block 1 Lot 1 #015-333-01 S-c-7— Y1 MUNICIPALITY OF ANCHORAGE ;,,, ove4 On-Site Water&Wastewater Program , Pd Box 196650 4700 Elmore Road c •• . Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http:1/www.muni.org/onsite „ 1 cpartMt' r 4hCMO2 r.GE On-Site Wastewater Disposal System Permit Permit Number: OSP171218 Effective Date: 8/10/2017 Work Type: SepticTank Upgrade Expiration Date: 8/10/2018 Tax Code Number: 01533301000 Site Legal Address: LAKE 0 THE HILLS EAST BLK 1 LT 1 G:2639 Site Mailing Address: 11171 MOUNTAIN LAKE DR, Anchorage Owner: JOHNSON JANET M Lot Size in Sq Ft: 30074 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907)343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. Relocate tank so that no portion is under the driveway, unless this will put it inside the 100 foot radius of the well on Lake 0 The Hills Block 1 Lot 1. 2. Provide double cleanout downstream the tank. 1� Received By:LicA. ,;�'L. 10, Date: e+ � ^ �' ^ 8 lo ,10( Issued By: f�k, ' �c, I � Date: MUNICIPALITY OF ANCHORAGE (or- . -.10 (.\ 4. Community Development Department . ` � Phon- 8 o •04 Development Services Division �� . . `0 - • 9• On-Site Water& Wastewater Program / /, '1; + -0 ON-SITE SEWER/WELL PERMIT APPLICATION AUG 0 9 2017 t- \-, l:o rrti Parcel I.D. 015-333-01 c iz c.)n� Property owner(s) Janet Johnson Day phone '91e L Mailing address 200 W. 34th Ave. #1172 Anchorage, AK 99503 Site address 11171 Mountain Lake Drive Legal description (Sub'd., Block & Lot) Lake 0 The Hills East B1 L1 Legal description (Township, Range & Section) Lot Size 30,074 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ❑X Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ 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. k,, .i (Signature of property owner or authorized agent) Permit/Rush Fees: 4022�6" Waiver Fees: Date of Payment: Y/1 I/r7 Date of Payment: Receipt Number: 6401400 Receipt Number: Permit No. 0S1211-targ Waiver No. Permit App__-:• ::..:c Pannone Engineering Services 'lc Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com August 9, 2017 Subject: Lake 0 The Hills East B1 L1 Tank Replace Permit Request Design Narrative This is a design narrative for a permit to install an upgrade 1,250g Septic Tank to replace an existing 1,250g Septic tank to be issued for this property. The existing tank has completely failed. It will be decommissioned per code. Currently the lot is developed. The proposed system will utilize a replacement 1,250g septic tank that will be connected to the existing drain field. The existing tank is located approximately 100'+ from the well. The proposed tank will be placed outside the existing well radius. All required separation distances will be met. 1. Upgrade Tank Design. A foundation clean out installed if needed. The tank will be located: 5'+ from any property line or building foundation 10'+from any water line 100'+ from any surface water 100'+ from any private wells 200'+ from any public wells The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, • • • • s Steven R.Pannone • \ c?4,1;511...",> Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage. AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 70 n11 10.” 117pl 6t,y „/IUNICIPALITY OF ANCHORAGE l 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 •NEW C., kr, 56) -.13Z3 [--]UPGRADE_ MAILING ADDRESS g 4 S'i�cz Ct'r� LEGAL DESCRIPTION E o..ft T 12 ►� 3 3 LA K e1% 4 1'�i `�S iy't ( B la�-\e I SC • 272 LOCATION �j"ar'l �� K NO. OF BEDROOMS - Well Absorption area q Dwelling irq PERMIT NQ. ©�©7 I CL TT Uy DI STANCE TO: Gamm 9 Yeo'+ wQ Manufacturer tt--G � to �1 Material��eR) No. of compartments N Liq. capacit� in g 11 s bb VV IF HOM MADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. O DISTANCE TO: _ F Manufacturer Material Liquid capacity in gallons D Well Foundation �' � Nearest lot line PERMIT NO. JDISTANCE w = TO: A>rll/i-) �- W u- U J z No. of lines yp� Length of each line Total length 99f lines Trench width ` Distance between lines/ Z t. zw /C�� 2 inches ~ a h Top of the to finish grade Material beneath tile •� Total effective absorptionarea y ? `-7 ® 7 7 inches , Length Width Depth PERMIT NO. W 0 Q F- Type of crib Crib diameter Crib depth Total effective absorption area as Lu Lu rn Well Building foundation Nearest lot line DISTANCE TO: Pas Depth Driller Distance to lot line PERMIT NO. J J w Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER A iee nt PIPE MATERIALS f9 r3 A C CI r e`9 SOIL TEST RATING 2� una' 36e �E� INSTALLER j Ty 0 REMARKS l n,l e.ft el 6 ` e� e M o/} ST u boa 6e e `'!r -3 exctua f 3Z -fee,•f . c.reve— tz S e .#i- d. fa�� Gr7 eh fy,c .r rl� s APPROVED LEGAL rl,21' OU 5tc23{¢ f+D_ATE j�j �t �� xJ7 e/vo %-Z2J. /'r!*1!S �r� !,(D 70 n11 10.” 117pl 6t,y vl _, — d0 NUhI�rPjLITv ,)c 'icX0R , A2 .< DEP ARTMTcYT OF LT'4 AND NVIRO M vNTAt PR:OT_CTION SzA 'rr ANCNc?RA K 94 O - ", 5 HERMIT NJ: "4s'7h1 ` s - DATE ISSUE' 39/07/ _34 - - -- Ar^,LICANT: J0,N _'RGPp 2 ADDRESS: 6440 STACEY CI='.CL` CONTACT 'PHON,- iA1 732 Id S e-}c'=sC^rlt�; SU9DIVISION- LAKE i TH` !ILLS ,� t��L' T: 1 T A SJ �• J' ry i i" 4 s'. V ,•� 4 t • I BLOCK: 1 u� LOT SIZE: 0 i;74 (S.FT. OR 1Ea) ,1• -sl AX ✓cDR0U;AIS: 2C -. LISTED LOGY APE THE Cp7.i�gS G.21n':L� r, T YOU IN D-a:C'ai"a YOUp SEPTIC 2 CHGOSv Th_c OPTI3N T-4AT F _� — — _ _ — JT F S S � 'J r? DTT:. — 3 — _ _ _ _ _ _ _ 2 Cid _ — — — — -- — — _ — / T P( I - V c -;. } a �`. 7 i �j EPF+1 FO PIFL .,OTT3 - {'r T.) - �4�% , t%j(i- > / / _ GRAVEL D=PTH (FT,) 4.0 TOTAL DEPTH (F T. 1:y,:sr i 3.S „ - - 6 s�.-AA/---L W s D T F (-F T - 4.5 7,5 25 ,) ?. _. GRAVEL LENuTH (FT.) 1 �• ? , .� GRAVEL VGLUii_ (CJ.YDS.) .,.. --T-A-,qK aC�L.=-;� (is I'1�-?) 'iv253.�31 �F�t 7 a� 97.8 - J;IL RATrN' (Si,x.'T./3R)a0 * ' 39 0 .:..+ 6 105 33 --- ** LflAV�L EY�Tit > 7 FT. ?r -''UDR S MJLT''LE ?Ui4S {NOT_EXvc=DZN G ?5 I5F ** TANK ?^UST HAVE AT, LEA JT T40 C `IPART-•}_ FT. EACH yTn — — — — e J e a .. vl _, — d0 A2 .< 33 tTIFY Th.AT: I AM FAMIl IAF,, WITH T4 RE UrRr_?,MN'rlS FOR n;N'Tc hEfiS AND sJELLS AS U'i1LIPA' T. TY OF AN-C"RACE (IMOA) - i�.D Ti+= ,Tn - OF I WILL II+;STALL THESYSTEiv 1`4 AC CO RD�i(;^c *T . A , 0A F- AN AL ASKj ,o�'_, rt ALL A DFe AND �awU! A.dD IV CO T iN F WIT H TJ -f4 ^ESI'. N CRI r aRIA )F THTS DERMIT. -%-WIL-L ADHERE T4 ALL- r{UO�i 4,}? =TATE JF ALASK4 _yTS FOR THE S, DISTANCES FROM :ANY EXISTING W':LL/ "rSP,?SAL SYSTE;'A OR Pu:- SEWERAb'- J, YST=Ai C;J THIS3)R ANY:ADJA{r='aT OR .r_A .; Y LOT. I U'JG RST.17tD THAT THI S P E z 77 IS VA. i �O S i �CXI�U�' OF ANY ENLAR:;�--,<F., 1,- 4 EDROOMS 4T IL 4 .-x :F 'A i ADDIT10NAL -IF A LIFT -STAT -TON -1S .NSTA _L -co -_`i AN AREA,, ry%Vcaci <y M)A _'"T4D,N- CODESI FiY=N (9) R`d :LcCTAICAL PER';_T ANDhS^YCT"a ,"7ST. =:L O'aTAI'J=D; {?) AS-' BILL"N;T W'. APPROV-D WiTHLJT ,A `v cL=CTRICAL I;3SrcCTiGti REp ai -- _L�E�r2I-�AL�WORK UiT 69- n _ v L1C_ REPOIT.; A.SD (3) T' {i L- `a a r a A .. � 'i t— i C ! ._ L T � i t, I � t� . �.- - SOILS LOG 5 MUNICIPALITY OF ANCHORAGE ER a f DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: `Sb�xh Oro-vy r k DATE PERFORMED: Sett- � 190 1 1++ LEGAL DESCRIPTION: 1.d-� ot V-1T�2 [Tl I.S SLOPE SITE PLAN gSlk >,�)So��o�KS c3o �+A WAS GROUND WATER S ENCOUNTERED? N" L O P E IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop N/0 1`2 K/S 3 -2- -4 — s- � r=w�rcl IAA r CERTIFIED BY: 3 3 '4 td yg o9 33� 59 2 3L($ Ii Sb o� g i b /o / GG 35k' S� 3 os - "t PERCOLATION RAT 33 (minutes/inch)3 COMMENTS OJ 1-0'�2_� Z�7�''%���/a N/0 1`2 LL Pt� /2- /G /�Pi.r' r^S' ✓�:f cin-/ly Tu'7�76 /SLl��L� PERFORMED BY: to r=w�rcl IAA l� $1-8`(02- * CERTIFIED BY: DATE: !211611g --v g- 72-008 (6/79) • u�� � 8 9 ro '• Qv Municipality of Anchorage ry N (° On-Site Water and Wastewater Program (907) 343-7904a JUN 08 ;, ,Lao 1r Certificate of On-Site Systems Approval' > � 0/ 6 Parcel I.D. 015-333-01 Expiration Date: C9 r L 1. GENERAL INFORMATION Complete legal description Lake 0 The Hills East. Block 1 , Lot 1 . Location (site address) 11171 Mountain Lake Drive Current Property owner(s) James & Janet Johnson Day phone Mailing address 200 W 34th Ave #1172 Real Estate Agent Day phone 2. TYPE OF DWELLING: D Single Family (w/wo ADU) El Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage El Holding Tank El Community Class A Well Community ❑ Public Water System ❑ Public Sewer El WaiverNariance request for: Distance: • Received b .i ��� !. f� Date: /1-// yi 7- — , l COSA to be release. to the engineer, unless btherwise requested b rie engineer. COSA Fee $ 5J--f26 Waiver Fee $ Date of Payment w1 Siff Date of Payment Receipt Number Qgg556 Receipt Number COSA# 05 0 gra 3) Waiver# 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe 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 life of all wells and septic systems depend on the local soil condition,ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 6/8/2017 4-:Z pF Aqs k 1- } *' ! ' iN *TAj 6. DSD SIGNATURE �� �, // System #1 Approved for if bedrooms• • Sleve .ri R. l5annone System #2 Approved for bedrooms CE-8149 Disapproved Conditional approval for bedrooms, with the following stipulations: ' otivtV ey( CI C OH be et , .�-+ cu( •eal 4 ate, %cue_ USG l `tomJz aV ITt EfiVaw � AT7 9 Y l-61TE TER AND 7. PI`OGHAM c? By ` Original Certificate Date: lir C� -1 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 XNitrate Advisor Septic System Advisory Arsenic Advisory= Well Flow Advisory Other '. COSA blue sheet r - ,. If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Lake 0 The Hills East. Block 1 , Lot 1 . Parcel ID: 015-333-01 A. WELL DATA Well type Class A If A, B. or C provide PWSID # 213603 Well Log (Y/N) Date completed Sanitary seal (YIN) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m g.p.m. WATER SAMPLE RESULTS. Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/24/84 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 6/7/2017 _ Pumper Isaac's Pumping Service C. ABSORPTION FIELD DATA Date installed 9/24/84 Soil rating (g p.d./ft2 or ft2/bdrm) 300 SF/BR System type Deep Trench Length 30/72 ft. Width 24 ft Gravel below pipe 6 ft Total depth 9 ft Eff. absorption area 1224 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7/8/16 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 2 in. Elapsed Time: 160 min Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. No Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas 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 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 200+ F. COMMENTS G. ENGINEER'S CERTIFICATION 4 ,llgkkk0 I certify that 1 have determined through field inspections and pj' : �)�'•y # review of Municipal records that the above systems are in ;4r; 4911-1 ,I' -.44-74 conformance with MOA COSA guidelines in effect on this date. %1---• ••• • + - i_ __ Engineer's Printed Name Steven Pannone ':Sieveri*It.*iriorie.• 6/8/2017 4} 4y% CE-8149 Date / A40FE5Sl �� COSA canary sheet_2-6-15.doc Boos 8 MOUNT-A/N LAKE pR/VE- Al 89°57`//"e /20.72 ler Z0.0 I i , 0 /OE[EC. ESM T. o. S . jr•,, \\ .� w000e� rJP SuBD/Y/Q/ON `' S/�{�Y j i jAry•,/ ESM T. • : 'r,�. �l '"� jfiE`+y?. / •( . 1 }` \ N ?1 .Tt� e.4 ci 1. `' /fes} ? i , yyti , a� ygy d : ••,f / f 6 }I `? 23.0 G"'e.p 3.o t8 J4 . O 2,0 t) N 20 O.H. co c Q 6.o +R Q'1 {' d0 N J 7�/rn � r��• �r ,.t , 5 e v CO d /3.a HS`�• o CL F Do v✓ Me' ' , jrl7 +bo 17. '^-I o N I .rib. 4 a 2.0 o.N. ,i ‘47 '���la�, OF A i Pq op,,....•�gs ii Deck x / " irA. 1 to ' r iv 4.- %17 1 N LOT / � . ... . .._ .. Q 1 p� • Fred Walcrkc .o o te r+s� ;`` a NO. 3255-5 ' my y,/x;d ref• waiI.> fdechmoo . — t 1k) °•.......•'' `"� s a�0� ti,. s ¢17rr cr✓e2 ria 7' 5'he'�f, III t‘ �,S,�rrat�+ Recerfi4ed 8-/6-84 07,k Ic-I4-a6( )!9-1714 )$, AS-BUILT NO CORNERS SET THIS DATE \O QI hereby certify that I have performed a Mortagee's in- 9 spection of the following described property: _ L 0 T 1, N BLK /, LAKE 0' THE ///L/ EAST Sueo/V/s/ON Anchorage Recording Precinct,Alaska,and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no SCALA 1 r_30 d' roadways,roadways, transmission lines or other visible easements on said property except as indicated hereon. c'o- Dated at Anchorage,Alaska .c. s- this -f TN day of Dc TO ER 19 84 EASEMENTS OF RECORD, OTHER AN THOSE SHOWN ON THE RECORD-' JD FRED WALATKA & ASSOCIATES PLAT ARE NOT SHOWN HEREON. 6� Engineers and Surveyors .? ,a`6 S3-2 t15 Municipality of Anchorage ° .. Development Services Department �' Olt Building Safely Division ' On -Site Water and Wastewater Program , ° i „ ° 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 0IS-333-01 COSA# �If(15a2- Expiration Date: / n - .2 6 - 0-7 1. GENERAL INFORMATION Complete legal description L-46 U it,c H:us Eml BM Loo 1 Location (site address) III -+I Mo. LK'k, Dr've. Current Property owners) 111 TpVv, so., Day phone 3`16—ZS-41 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address PO Doc '24'z164 An %., n c AK 49524 Unless otherwise requested, COSA will be held by DSD for pickup. Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 Spur R\alnel Engineerinn Address 203 W. 1511 5f , Zo , Ancl,era,i-A K 995ol Engineer's Printed Name L -Ars SDur17-\ c� 5. DSD SIPNATURE V Approved for bedrooms. Disapproved. Phone -.71- 311 b Date 1011-410L ��.QF A-�gs111 LARS E. SPURKLANO." 11500 I llkk F SI�`��".y Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other B.� i ,z3e' Y y' Original Certificate Date: b "� (R . 11M) Municipality of Anchorage Development Services Department ` Building Safety Division On -Site Water i3 Wastewater Program ' 4700 Bragew Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsits (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal peaaiption: L-A. O' }be ":11s 1-&,J__BiK1 L-ot 1 Parcel ID: O I s�_ 3 33 - o / A. WELL DATA Well type Counrq, N A, B, or C provide PWSID 0 Z 13 4003 Well Log (YM) Date completed _ Sanitary seal (YM) _ Wires properly 01 1N) Total depth ft. Cased to ft. Casing h ' (aboveground) in. FROM WELL LOG NSPECTION Date of test Static water level ft. Web production g.p.m. g.p.m. WATER SAMPLE RES Colifocotonlea1100 ml rm Nitrate mgA. Other bacteria cobntesll00 mL s:: mg/1 Date of sample: _ Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material AV% a Date installed ZY 6 y Tank size 1250 gal. Number of Compartments Cteanouts (YIN) y Foundation deanout (YIN) y Depression over tank (Y/N) N High water alarm (YIN) NA Date of pumping _tl It, lob Pumper Ts saL S FugpD q C. ABSORPTION FIELD DATA Date installed 9 2Y o i34 Soil rating (g.p.ddfe or(s�ji 300 system type Peep TQC',' , Length 30 "} 1 ft. Width 2 R Gravel below pipe R Total depth 10 ft. Eff. absorption area 122 fe Monitoring tube y Depression over field N Data of adequacy test o 3 0 Results (Pass/Fail) Pz,s For'_ bedrooms Fluid depth in absorption field before test ($ 391 Water added 6 gal. New depths n ENn V., wu"l'n ��'t�te� Elapsed Time: 151 min. Final fluid depth 3G Iin. Aoaorpson rale >= �O� g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) /1/0 If yes, give date IF04?tV% � "'.0 S%efae't # i fr-oro leoRor. Sygft.... `�j_ Spurkland Engineering Environmental Consulting and Design October 17, 2006 Municipality of Anchorage Development Services Department Building Safety Division On Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519 Subject: COSA REQUEST LAKE O' THE HILLS EAST BLOCK 1 LOT 1 Dear Jeff Poet, The septic tank lies along the west edge of the paved surface in an area not normally used for parking. A 1250 gallon steel tank has the following dimensions: 5 -foot diameter, 10 -feet long with two cleanouts, located along the center line at either end. Based upon this configuration, less than 10 % of the septic tank is located below the driveway. The top of the septic tank is 5.5 feet below the ground surface. The cleanout for the septic tank is protected by a steel cap, marked sewer & flush with grade. The location of the septic tank does not create a safety hazard and has no effect on its function. If you have any questions, please contact me a 279-3916. Sincerely, s _ � o . .• l FA Cqs l I 1 � I � ,�,Q�. • `rte if Lars Spurkland, P.E. .49T—" , t • •,� Spurkland Engineering r- i' -A-- LARSs�uaRu ill �ca nOFESS`,0�• 203 West 151b Avenue Suite 203, Anchorage, AK 99�f, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEngCaa)gci.net Spurkland Engineering Environmental Consulting and Design � October 17, 2006 Municipality of Anchorage Development Services Department Building Safety Division On Site Water and Wastewater Program 4700 South Bmgaw Street P.O. Box 196650 Anchorage, Alaska 99519 Subject: COSA REQUEST LAKE O' T1IE HILLS EAST BLOCK 1 LOT 1 Dear Jeff Poet, During the COSA review process it was discovered that a potion of the septic tank and 32 feet of drain field (approximately 44 % of the absorption area) serving the above referenced lot lies beneath the drive way. The septic tank lies along the west edge of the paved surface in an area not normally used for parking. The top of the septic tank is 5.5 feet below the driveway surface and does not lie within the typical travel lane (i.e. vehicles would not typically travel over the trench to access the garage). The cleanout for the septic tank are protected by steel caps, marked sewer & flush with grade. The trench has been in service since 1988 and the recent adequacy test did not indicate any adverse effects do to the driveway. If you have any questions, please contact me a 279-3916. Sincerely, I Lars Spurkland 203 West 1510 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net y SCALE 1'• 30 MOUNTA//V LAKE pR/VE N 89`57'//"E /20.72 20.0 IJ/O'ELEG. ESM T. �QOD6N Sa a U 0 t.o o CIN. V N [17.o m o � 5 01 i p of Bo a Se o 3.0 0 0 N '� 2.0 O.H. F A Deck LOT / w.od ref. walls # deck s'_ Z fh�3 o✓ta 17of s/1ewn, 1"?e,cerf� AS=BUILT NO CORNERS SET THIS DATE 0 0 0 C BOOB 8 h o red CLF Day Rw w/netyi,bo✓ EASEMENTS OF RECORD, OTHER -VAN THOSE SHOWN ON THE RECORD STD PLAT ARE NOT SHOWN HEREON. s, �6 e4.200 i. 53 I hereby certify that I have performed a Mortagee's in- spection of the following described property: 407' /, _;03 ✓ / LAKE O' THE 14/11-5 rA57_ 5 U8 P/V/S /ON Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach an the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 71H clayoi 40G70®ER 19 84 FRED WAI,ATKA do ASSOCIATES Engineers and Surveyors Municipality of Anchorage Development Services Department ae Building Safety Division °- On -Site Water and Wastewater Program a 4700 South Bragaw St. S E P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Lars Sourkland Legal description: Lake O' the Hills East Block 1 Lot 1 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on — ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ® Incomplete; missing Pumping date ® Incomplete; missing Community Well Number ® Additional adequacy test information needed. Readings must be from bottom of system. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field.— [D Other. Tank cannot be under drive, Name of reviewer. Jeff Date: 10-24-06 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK 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 R/ I 116E 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) r`uf 11 8toc1. 11, G,cal-e C/ ihy Pr(ls7 _p7C'.sl -5 ID Location (address or directions) 1 r /7( Houn4vin l e Dr,,�� (b) Applicant Name T -An e R(kig PnW7 Telephone: Home 2( Business Applicant Address 1117( 1`(vun il¢rn /er(P iirr « /}n� chc7 {s A (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ®; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Ei rS ¢ Zn �e�r PC��E £3ero k Telephone 2 6'Y - S6"7 0 Address _Sk Anchorage, A 995 -OJ (e) Real Estate Company and Agent Dvn am i c Rea I/,/ dct ace Address AlorAern A(y TS(vc( AnCAr>,-c�yt Alf "SGS Telephone 279— 7 I (f) Mail the HAA to the following address: ((-laic( for eick -u® s 2. TYPE OF RESIDENCE Single -Family($ Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well ❑ Community [I 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 OnsiteIR 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. Page 1 of 2 72-025(11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 shows that the on-site water supply and/or wastewater disposal system is sate, 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 F(cc E6�e %echnicol C Telephone Ys_ - lxjt-S Address l h S31� C��iv �¢ igachor'cecyle A !z 9951( Date Au utf !`i 19b�K_ 0FeA4 � 4s �0 49yH e• ` ®•e000 eea 0oose•eyype;aaoo•ee•o� voaae e.eoXe a eeooaeee®n gineer's Seal L" a THEODORE F. MOORED � a �9® ,% CE - 3539 o e 6. DHEP APPROVE � 8 j Approved for �OU� bedrooms by 22 - ate ! kj Approved Disapprove Conditional Terms of Conditional Approval 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 (MOA) CiPALIP' ,- HEALTH AUTHORITY APPROVAL (HAA) p •,.�"' ; ""` CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: G �f 9 �3 ��� Ir 1 198 Geake �' 7-A 1/rl(S 'i rl fj i ' , _. A. WELL DATA Well Classification 111/4 J H II If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Date Water Sample Test Results Comments See D C—C le �4-er eel Com p (7q17 c 'r�&Fdr'C e B. SEPTIC/HOLDING TANK DATA Date Installed ���`% � `� Size 12,5_0 clet ( No. of Compartments Standpipes (Y/N) Y Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) Y (in artveuiat) Depression over Tank (Y/N) N Date Last Pumped 49111160, Pumping/Maintenance Contract on File (Y/N) N< ; for NIA. Holding Tank High -Water Alarm (Y/N) N,/4• Temporary Holding Tank Permit (Y/N) N Separation Distances from Septic/Holding Tank: To Water -Supply Well &A, Comm /J4 0 To Building Foundation 3,9' To Property Line > 36' To Disposal Field 9r To Water Main/Service Line > ic' To Stream, Pond, Lake, or Major Drainage Course 1,60' b (u (=e Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata '300 n `/aaor Type of System Design Tre,�c6 Date Installed 9 / c'- / / 6"/ Length of Field 1 O e Width of Field lay it Depth of Field /00 Gravel Bed Thickness K, Square Feet of Absorption Area f 2,017/ Standpipes Present (Y/N) Depression over Field (Y/N) N Date of Last Adequacy Test fit/ 13 / 6G Results of Last Adequacy Test ruafe b , droomf Separation Distance from Absorption Field: To Water -Supply Well NIA. Comm 6 0 To Property Line 197 To Building Foundation e To Existing or Abandoned System on Lot NI/f. ; On Adjoining Lots Z' 30 To Water Main/Service Line IYO ' from Mae((er 0416le To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 190 ' fz, l a tTe To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION NA Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments n 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 'TY f 2 O" � Date 8//Y / 15'd' Company f=la)410P Tc/rircci S!&rMOA No. 96'"QP- Receipt No. 4--100 D G 20 Date of Payment q`0,<W Amount: $ QV Page 2 of 2 72-026 (11/84) ,aft,O o A4�(a�4 '• ® Engineer's Seal x r 49 V '• THEODORE I MOORE,• 0 ®� ••••• CE - 3589 •: -D 4�h �Pf0kSS!Q+4���� G 1 BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE: August 8, 1986 PWS I.D.# 213603 To Whom it May Concern: According to records on file in this office the LAKE OF THE HILLS EAST Water System is in compliance with the State Drinking Water Regulations Sincerely, Michael P. Lewis Environmental Engineer