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HomeMy WebLinkAboutSOUTH LAKEWOOD HILLS #1 BLK 3 LT 4Onsite File x Per 2019 as-builT survey,, the drainf ield is less than 10 ft -from the north lot line. waiver This will require a .; issuance of a COSA. L NAM .,,��.. rye.: �`✓` �� �` '��5� � ,.��` �' ^� � � f ai w` c* - X3.'""3' Municipality of Anchorage V 1 Community Development Department '2Z019 Pag 1 of 2 On -Site Water and 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: OSP181390 PID Number: 015-151-17 ❑ New ❑✓ Upgrade Name: Wesley & Cyndi Saunders ABSORPTION FIELD ❑ Deep Trench El Shallow Trench E] Bed Mound Address 6400 Woodmont Drive [:1 Other Phone Number of Bedrooms Soil Rating Total depth fr original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot South Lakewood Hills #1 3 4 Fill added above original gr Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic I Absorption Lift Station Holding Sewer rption area Number of trenches Dist. between trenches From Tank Field Tank Line. T�otala Flt Ft. Well 100'+ I 25-1 TANK El Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1250Gal. Surface Water 100'+ Material Number of compartments Lot Line 5'+ I Steel 2 NA Foundation 10'+ I LIFT STATION Manufacturer Capacity Curtain Drain 50'+ I Gal. Remarks Pump on level at Pump off level in. High water alarm at in. Pump make an odel Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 Jr's Septic Services Drainfield CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 652.5ft InspectionLocation dates: 1' 11/6/18 2-11 5/9/19 and description 3°' 4 ° Bottom siding house point B COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: O A��>�� Date ,� ��G �t6;en annone ApprovedW D301, ( ate °I 3U , q E 8149 O -- _ NO WELLS W1 200' — �V \ I TRUE NORTH SCPLE "- 50' WrCrGD M ON T-_ Drive , i DRAIN FIELD E 1 INSTALLED 1250 SEPTIC TANK T T W/ DCO AFTER. \ l� 2c, 3 4 A NN f REMOV 50 SEPTIC TANK E � / V� PER MOA 'DE f 635 / I 4 BDR L--� SFD I n �GARAGE 640 1 DRIVEWAY �_ -� `65s w — , _ ,64s � , _ I 650 zi I 0 WELL E L* 1 /----i ALL MEASUREMENTS f 1.0' l /— — \ 0' Utii Esmt NO WELLS W/ 200' , I I w w WATER LINE / WELL RADIUS NEW SEPTIC EXISTING SEPTIC TH A B CO 32.4 18.3 T1 40.0 24.5 T2 46.1 30.1 DCO 1 49.2 33.0 DCO2 49.9 33.7 NO WELLS W1 200' — �V \ I TRUE NORTH SCPLE "- 50' WrCrGD M ON T-_ Drive , i DRAIN FIELD E 1 INSTALLED 1250 SEPTIC TANK T T W/ DCO AFTER. \ l� 2c, 3 4 A NN f REMOV 50 SEPTIC TANK E � / V� PER MOA 'DE f 635 / I 4 BDR L--� SFD I n �GARAGE 640 1 DRIVEWAY �_ -� `65s w — , _ ,64s � , _ I 650 zi I 0 WELL E L* 1 /----i ALL MEASUREMENTS f 1.0' l /— — \ 0' Utii Esmt NO WELLS W/ 200' , I I w w WATER LINE / WELL RADIUS NEW SEPTIC EXISTING SEPTIC TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. MT MONITOR TUBE NO TYP TYPICAL z� o� pAMQNLi ENG SVC, C LLCDate P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211• D s/219 Qo o O �w w w w 0 m O PERMIT NO. OSP181390 SITE PLAN O iU U U pV O.G./F.G. ,., n n 1250g SEPTIC TANK 64?_.7 CONNECTED TO DISCHARGE PIPE (E) PROFILE SCALE: NTS NOTES: pAMQNLi ENG SVC, C LLCDate P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211• ��'••.�� ... . .. ... ...... {ems anrio�ae� CE 8149 •� s/219 RECORD DRAWING - Scale 1 " = 50' SOUTH LAKEWOOD HILLS #1 83 1_4 WESLEY SAUNDERS 6400 WOODMONT DRIVE ANCHORAGE, AK 99516 P.I.D. NO 015-151-17 DRAWN ACP PERMIT NO. OSP181390 SITE PLAN Sheet 2OF2 49TH*** .......................... STEVEN CALLAGHAN.: 21 I -S-12034 ORDERED BY: WES SAUNDERS 250 H Street LEGAL AS -BUILT Anchorage, Alaska 99501 DESCRIPTION: LOT 4, BLOCK 3, Survey Department SOUTH LAKE WOOD HILLS NO. 1 Phone 562-5291 SUBDIVISION Mainline DRAWN DATE: 2/4/2019 WORK ORDER: 19002 Phone 243-8985 DRAWN BY: AS PLAT: P-611 AECC 668 CHECKED BY: SC GRID: SW2638 SCALE: 11. = 40' FB/PG:812/43-44 REF: 011_474 LEGEND: 26.0' 30' i NOTES: 1. SNOW AND ICE MAY CONCEAL MINOR SURFACE FEATURES. 2. THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANITECH. ADDRESS: 6400WOODMONT DR. PARCEL 015-151-17-000 SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTEDA PHYSICAL SURVEY THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THATTHE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. Gravel SEPTIC STANDPIPE EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE Concrete EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY WATER WELL 'Overhang TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO FENCE —X—X—CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR Wood_ De-ck— -- - � ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES. ce) ------ 30' 26.0' 30' i NOTES: 1. SNOW AND ICE MAY CONCEAL MINOR SURFACE FEATURES. 2. THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANITECH. ADDRESS: 6400WOODMONT DR. PARCEL 015-151-17-000 SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTEDA PHYSICAL SURVEY THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THATTHE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. Gravel SEPTIC STANDPIPE EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE Concrete EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY WATER WELL 'Overhang TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO FENCE —X—X—CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR Wood_ De-ck— -- - � ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES. MUNICIPALITY OF ANCHORAGE _ On -Site Water & Wastewater Program on POBox 188850 47OUElmore Road Anchorage, Alaska eos1s'snsn phone: e04 Fax: (oo7)o4o'rse, ~ mtp:owww.mvni.uwbnsite ~ * De pa I -till e 111 On -Site Wastewater Disposal System Permit Permit Number: OSP181390 Effective Date: 10/30/2018 Work Type: SepUcTankUpgnado Expiration Date: 10/30/2019 Tax Code Number: 01515117000 Site Legal Address: SOUTH LAKEWOOD HILLS #1 BLK 3 LT 4 G:2638 Site Mailing Address: 84OOVVOODK4ONTDR, Anchorage Owner: SAU0DERSWESLEY E&CYND|L Design Engineer: PANNDNEENGINEERING SERVICES This permit is for the construction of: Lot Size in Sq Ft: 3200 Total Bedrooms: 4 [] Disposal Field Septic Tank Holding Tank E] Privy [] Private Well [] Water Skznage All construction shall beinaccordance 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 VVaobewuhor 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 i5.6S.Provide notification bycalling (807)343-70O4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall bueither: a. Opened and Closed onthe same day, or b. Covered, sealed, and heated ioprevent freezing Special Provisions: Septic tank shall be installed only in an area that will be readily accessible for pumping 15.65.205B.2). If tank is to be installed beneath the deck, provisions shall be provided to allow for regular pumping Received B) Issued By: / Cd SH MUNICIPALITY OF ANCHORAGE - Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-151-17 Property owner(s) Wesley Saunders Day phone Mailing address 6400 Woodmont Drive Site address 6400 Woodmont drive Legal description (Sub'd., Block & Lot) South Lakewood Hills #1 B3 L4 Legal description (Township, Range & Section) Lot Size 32,000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X Septic Tank ❑X Upgrade ❑x (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 96 4- 129 Waiver Fees: _ Date of Payment: 10 12�d« 1 i Date of Payment: Receipt Number: 6_37 9 --lb Receipt Number: Permit No. —4 Waiver No. orj,)gg6 Permit App_.'-:- .'-..:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181390, Rebecca Carroll, 10/30/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181390, Rebecca Carroll, 10/30/18 - . MUNICIPALITY OF ANCHORAGE DE RTMENT OF HEALTH AND HUMAN SER ES Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address ~ ~ Z ~ TANK FIELD Phonets) Township. Range. Section AS-BUILT DIAGRAM (Show location of well septic system, property lines, foundation. TANKS I ~ SEPTIC ~ HOLDING / TYPE OF SYSTEM ~TRENCH ~ BED d W. DRAIN G OTHER M:~ ~ PRIVATE ~) 7-~7-~ OTHER (Identify) RE.ARKS: Health Depad.en, Approval: ~¢:/ . Date:'7-- 72-013 (3/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502~0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) 1 2 3 4 5 6- 7- 8- 9- 10- 11 13- 14 15- 16- 17 18 19 2O WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After ,,.,. Moniloring? ~ ONJ:3 Date: , [,,, o N ACCORDANCE WITH A:L STI~ ~ND MUNICIPAL GUIDELINES IN-EFF/CT ON THiS DATE. DATE: PERCOLATION RATE /,,.~) (minutes/inch) PERC HOLE DIAMETER Gross Net Depth to Net Reading Date Time Time Water Drop No ~/eL[s Acposs C,L, Woodmont Dp, S89°59'00'E S~cpee~, 200,00' Exi~A:ln9 ~£5~ 6o~, 30,00' o Ln RiO0.O0 °/ CD REOUIRED ADD BN TD 7' DF NEW 10' DEEP DF RDCK 4-I~eolroom Residence RIO0,O0 UPGRADE EXISTING TRENCH: 20 0 20 40 60 80 I00 120 TBBBEN SPURKLAND P,E, 203 W. 15TH, AVENUE ANCHDRAGE, ALASKA (907) 279-3916 LRT 4, BLBCK 3, SB. LAKEV/BB]) HILLS SEC.23, T18N, R3~/ HERPINOTON, E$CHBACHER SEPTIC SYSTEM DESIGN DATE, FE~, ~ 1988 SHEET,/ GR]D~B638 q.g ld'O ,,. 7 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL !NSPECTION REPORT ~ ~j~.~O~.' ]PHONE UPGRADE NAME LEGAL DESCRIPTION LOCATION L DISTANCE TO: Inside length I F HOMEMADE: Dwelling I.j/ W dth NO, OFBEDROOMS PERMeate No. of comparc~.~t~ Liquid depth Well Manufacturer Liquid capacity in gallons DISTANCE TO: Well ii¢~ .~ N°. °* linest I ben~th °~.~/~c,.~i~ Top of die to finish .gr. ade Len.qth Width Type o~ crib Crib diameter Well DISTANCE TO: Depth Building foundation Material Trench ' th Foundation Material ~eneath tile Depth PERMIT NO.~3' PERM,T Distance Total effec~i~v.e ~6s~rption area PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line Class Driller Distance to lot line IPtPERMIT NO. Sewer line Septic tank l~rea(s) DISTANCE TO: / OTHER SOIL TEST INSTALLER REMARKS APPROVED DATE LEGAL 72-013 . F:tPF'L. Z CI::INT ED. HERZOG LOCRT I ON WOODMOUNT L..EGF~L. L. OT 4 BLK 2: SO. STREET, RNCFIORFIGE, RK. 26:;4-4720 LRKENOOD HILLS T'¢PE Of:: SOIL.. RBSORF'TION S'-?STEM IS: TRENCH MRXIMUM NUMBER OF BEDROOMS SOIL_ RRTING (SQ FT,"[~R::'= 150 THE REQUIRED SIZE OF:' THE SOIL HBSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IH FEET) OF' THE TRENCH OR DRRINF'tEL. D. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETHEEN THE SURFRCE OF THE GROUND FIND THE BOTTOM OF THE E'.:.~CRVR]"ION (IN FEET). THERE IS NO gET I,`IIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETI4EEN THE OUTFRLL.. PIPE FIND THE BOTTOM OF 'FHE EXC:RVR]"ION ,:lIN FEET). F'ERMIT HFFLI_.HN7 HHz, THE F:.E,:,FLff.&~,IE, ZI_[I~ TC [HFORM TH~_, [EFhR~MEHF DURZNG THE INSTRLLRTZON INSPECTIONS OF RNh" f.,tELLS RDJRCENT TO THIS PROF:'ERT'~' AND THE NUMBER OF' RESIDENCES THRT THE WEI_L 14IL. L. SERVE. E.'FICKFiL. LING OF RN'¢ SYSTEM WITHOUT F'INRL. INSPECTION RND FIF'PROVFtL BY THIS; [:,EPF']RTMENT WILL E:E SUBJECT 'FO PROSECLITION. MINIMUM DISTRf-`IC:E BETWEEN R WEL. L RND RNY ON-SITE SEHFtGE DISPOSRL SYSTEM iS 100 FEE"f' FOR FI PRIVRTE I,.IELL OR :1.50 TO 2.00 FEET FROM fa PUBLIC bIELL DEPE]'.,IDING UF'Of.`I THE TYPIF OF PUE[LIC .~,~ELL. MIHIMUM DISTRHCE FROM I::t PRIVFFf'E WELL "FO Fi F'RIVFITE SEfdER L. INE IS '-25 FEET FIND TO F:I COMMUNITY? SEWER LINE IS 75 FEET. kI[CLL LOGS FIRE REQUIRE[) RND MLtST 8E RETURNED TO THE DEPFIRTMENT P`IITHtN 30 OF' THE !dEL. L COHPLETION. OTHER REQUIREMENTS MR't' RPF'L~r'. SPECIFICRTIONS FIHD CONSTRUCTION [:,IFIGRRMS RRE RVRILRBLE TO INS;URE PROPE:R INS'rRLLRTION. I C:ER"FIF'¢ 'T'HFtT ::L: ! FtM FIRMtLIRR HI'TH 7'FIE REQUIREMENTS FOR ON-SITE SEWERS RND HELLS RS SET FrORTH B"¢ 'T'HE MUNICIPFILIT'¢ OF' RNCHORRGE. 2: I HILL INSTRLL THE SYSTEM IN RCCORDRHCE NITH THE CODES. 3:: I UNDERSTRND 'THRT TF!E ON-SITE SENER SYSTEM MR"r' REQUIRE EHI..RRGEMENT IF THE RESIDENCE IS REMO[:,EL.E[:' 'Ti:) INCUJDE MORE THFIf,I 3: BEDROOMS. V4. 0 SOILS LOG PERFORMED FOR: LEGAL DESCR'PT'ON: /...,- 1 2 3 4- 5- 6- 7- 8- 9- 10- 11 13 14 15 16 17 18 19 2O MUNICIPALITY OF ANCHOFV~I~EIPAL1TY OF ANCHO~AG5 D)F~P}-,_O_ E]P. OF HEAU'H & 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TES'IM/~!~ SLOPE WAS GROUND WATER '/~,%~_~ SL E ENCOUNTERED? IF YES, AT WHAT DEPTH? PERCOLATION TEST Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/inch) 72-008 (6/79) Well Log oca~lon...M..(...~f.~.....;..:..:~ .............. 7 ................................................................... Date completed ......... , ....... ::.:., ..... ~ ............................................................................ pth ' De of well ..... t.:~::, ............................................................................................... Size of casing ....... tx....~r ........................................................................................ Distance to water ~o.xl4 M~d~--~c-o ,~(, ......................................... Dist~ce to water while pumping ............. (,'~-.0 ............................ at r~te of ;'J~ h ...... gallons per hour.[, Forma'tion [ from [ to Driller DELTA DRILLING COMPANY SR^ SOY~.SSa. O ANCHORAGE. ALASKA 99507 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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. # ~:~)/'~-~- /,-~/~ )-7 HAA # 1. GENERAL INFORMATION Complete legal description ~ 4/! Location (site address or directions) Property owner -~/4~(¢~ 'J~_~r~-~ Dayphone '~;:5-775- Lending agency Mailing address Day phone Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: Z?'/ %, TYPE OF WATER SUPPLY: Individual well NOTE: Community well Public water If community well system, provide written confirmation from State ADECTattest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: 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~)25 (Rev. 1/91) Front MOA ¢Y~1 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 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, Phone ordinances, and regulations in effect on the date of this inspection. Nameof. rm Address ~ ;% ~.~ / ~ ,~.~ ~ ~.5Z¢ ~ Engineer's signature ~ .~-~,4.¢-~-~J-'~ bedrooms. DHHS SIGNATURE /~ Approved for Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments r/ / 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 DH HS 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) Back MOA ~f21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: LoTH,,~'I~'~, -~-~ ParcelI.D. OI5 -- JSJ Well Data Well type ~'- If A, B, or C, attach ADEC letter. ADEC water system number t",///~ Date completed ~, "~-- L~I Driller Log present (Y/N) y Total depth c/q-,~ .~ Sanitary seal (Y/N) y Cased to ,~)... ~Z. ~:~ Casing height Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Static water level ~' C) (.~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /O J~/' ; On adjacent lots ¢.~.¢.~) Absorption field on lot /0 ~ ~/' ; On adjacent lots Public sewer main ~///At Public sewer manhole/cleanout Sewer service line /~ ~L~ Petroleum tank WATER SAMPLE RESULTS: Coliform ~' Date of sample: ~7/'I~ Nitrate ~,~ }~ Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA - Date installed / Cleanouts (Y/N) 7 High water alarm (Y/N) Tank size /~.~O Compartments Foundation cleanout (Y/N) 7 Depression (Y/N) t"//A~ Alarm tested (Y/N) Date of pumping SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Sudace water/drainage On adjacent lots '/~'~ /' Foundation Absorption field /-'/'~ Water main/service line 72-026 (3~3)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N), "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA Length ~ .~ Width ~ / Gravel thickness /p ~ Total depth Total absorption area /~P Cleanout present (Y/N) '7 Depression over field (Y/N) Date of adequacy test '~'~ ;~/~ 5- Results (pass/fail) P for /7// Bedrooms Water level in absorption field before test~ After test ~,! ,~ ~/-~J-.~.r Peroxide treatment (past 12 months) (Y/N) ~-I If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot J (~ To building foundation On adjacent lots .~ Sudace water ,~,¢ Curtain drain /"¢ / ¢~ On adjacent lots / '-~ ~.~ Properly line /7/0 '/' To existing or abandoned system on lot Cutbank t~O ~ ¢_ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect.on the date of this inspection. Engineer's Name Date HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)° Back Waiver Fee $. Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTiFiCATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) (b) (c) Location (address or directions) Property Owner H~"v'~Z'v~'L"'*/~-~-d,~r-~-¢'/Telephone: Home Mailing Address Lendinglnst,tution U~t~ ~0~¢ Telephone Mailing Address Business (d) Real Estate Company and Agent Address (e) Telephone Mail the HAA to the foliowin(~ address: or: Check here/~, if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family/~ (7/ Number of Bedrooms , WATER SUPPLY Individual Well (~ Community [] Public [] / - Note: If ¢ommdnity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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. Page 1 of 2 72-025 (Rev 8/86/ Fronl ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARC ,H, 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 disposat system is safe, functionat 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 Name of F rm , c~ ---- ~ Telephone Address ' / . ~ '~ [J~/ /~ ~.,.-~1 Date ~ ]~ DHHS APPROVAL Approved for /Z~¢.~. ~/~bedrooms by Approved , ¢/~ Disapproved Terms of Conditional Approval Conditional CAUTION 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 DH HS 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. Page 2 of 2 72 025 fRev 8/86) Back :' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date ~ 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, town~ip~ ra~e) ~l~'['"~--/~~elephone' Home ~'~V~O .usiness (b) Property Owner _ · Mailing Address (c) Lending Institution N~~--. Telephone Mailing Address (d) Rea, EstateOompanyandAgen'- ~ L~ Address (e) Telephone .~ (~ ~' '"' 7~ '~ ~'~ Mail the HAA to the followina address: or; Check here,~, if hold for pick List contact person and day phone number below. -- up. 2. TYPE OF RESIDENCE ;'~fmg I;;Fr ao~ Ye~ r o o m s WATER SUPPLY Individual Well ~ Community [] Public [] Note: If communityt' well system, must have written confirmation from the State Department ol Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: IlI'community well system, must have wr tten confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72 025 fRev 8'86/ Front 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 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 el 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 °f this ins~t~ _ ~ ,~¢~~ Name of Firm ~ --~ Telephone Address .¢ ~'-~ ¢ Date Engineer's Seal · ^.,-,- ....... ..... '~ Di.c,~l~l~eve~ ___ Conditional Terms of Conditional Approval ~, ~~,",,~/,,~ .~--¢-¢~..~-'~'/,~,~' CAUTION 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. Page 2 of 2 72 025 fray 8/861 Back ,, ©?/,¢~CI4©',~/I~NICIPALITY OF ANCHORAGE (MOA) F~uNiCii"~'d ~ ~;;:,~F~ ~-,, U"i41~TH AUTHORITY APPROVAL (HAA) ~:N~ '-~' CHECKLIST- FEBRUARY 1984 ~)~ ~ 264-4744 Legal Description' ~ WELL DATA Well Classification Well Log Present (Y/N) Total Depth ~:,~' Static Water Level ~ Casing Height Above Ground .~/~.. Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Hefld~g Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by ? Cased to. ~¢~'~' Depth of Grouting ~"¢ g2 t'~~' Pump Set At ~ ~/ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (WN) If A, B, C, D.E.C. Approved (Y/N) Date Completed _ .;~'~--~" ~? Yield ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Water Sample Test Results N0¢¢~ To Nearest Sewer Service Line on Lot Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~/ Standpipes (Y/N) / Depression over Tank (Y/N) Size /~,~.,~O No. of Compartments Air-tight Caps (Y/N) / Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) _ Separation Distances from Septic/Holding Tank: To Water-Supply Well J~) ~ ''~ To Property Line ,~'~ ¢ To Water Main/Service Line _ Course Foundation Cleanput (Y/N) Date Last Pumped y~.,¢'/,¢'~" ;for Temporary Holding Tank Permit (Y/N) ~ To Building Foundation /~ To Disposal Field Z~/'O ¢ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026 fRev 8~86/ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field _ Square Feet of Absorption Area Depression over Field (Y/N) _ Results of Last Adequacy Test "~'~ Separation Distance from Absorption Field: 'Fo Water-Supply Well /g2 ~ ~ 'Fo Building Foundation ~) ~' 'To Water Main/Service Line ~/~:) To Stream/Pond/Lake/or Major Drainage Course 'Fo Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field t//.~ Depth of Field J ~ Gravel Bed Thickness ~-~ Standpipes Present (Y/N) Date of Last Adeg~uacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~ / To Cutbank (if present) _ D. I-IFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at 1 ested for Flectrical Codes (Y/N) . Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify t hi~b,~ checked, verified.,~r conformed to ale M O¢. and olgned ~' ~ Date Company MOA No. Receipt No. /¢¢ /~ _ D~te of Payment Amount: $ Page 2 of 2 HAA guidelines in effect on the date of this inspection. Engineer's Seal CONSULTING ENGINEER 203W 15th AVE 'C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279 3916 Department of Health and Human Services P.O. Box 196650 ANCHORAGE, ALASKA, 99519-6650 January 28, 1988 Subject: HAA Lot 4, Block 3, South Lakewood Hills Conditional Approval. Gentlemen; A Health Authority inspection and test was conducted on subject property on January 25, 1988. Both well and septic system tested satisfactory for a four bedroom dwelling. However the septic system as-built is ambiguous as to the physical size of the absorption trench. In 1981 a permit was issued for a three bedroom system for this property. From the as-built it is apparent that the builder intended to apply for a four bedroom approval. A 1250 gallon tank was installed and the trench is larger than specified in the permit. The inspector shows 600 sq. ft. of absorption area. However he also shows that the trench is 43 feet long with six feet of rock, equaling 516 sq. ft. Due to the deep snow and a substantial amount of rubbish, the size of the trench could not be verified at this time, so 1 have assumed that 43 feet is the actual length. The owner intends to escrow funds to upgrade the system after breakup, and requests a conditional approval be issued. MUNICIPALI'IY OF ANCHORAGE -, ~=iV~CE$ DIVISION ENVIIIONM~NTP'~ '~" C~0NSULTING ENGINEER 203 W 15ti~ AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279 3916 RESIDENTIAL WELL INSPECTION Lot 4, Block 3, South Lakewood Hills LOCATION: OWNER: TYPE OF WELL: 6400 Woodmont Dr. Herrington/Eschbacher Single Family, On Site WELL LOG AVAILABLE: Yes, INSTALLATION REQUIREMENTS MET:Yes WELL YIELD FROM WELL LOG: 13 Gallons per Hour, PUMP YIELD FROM TEST: 6.25 Gallons per Hour DATE OF INSPECTION: January 25, 1988 TEST PROCEDURE: Well was pumped at a constant rate while the drawdown was monitored with an acoustic probe. At the beginning of the test water level was found at 81 feet below top of casing. At a pumping rate of 6.25 gallons per minute the water level dropped to 131 feet after 90 minutes of pumping. A total of 600 gallons were pumped. The well recovery rate was monitored for 20 minutes. The well recover to 101 feet during this period, a 60% recovery. TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Coli and total nitrates on January 26, 1988. E.Coli 0. Total Nitrates ND.(Non Detected) Max. allowable Total Nitrates 10mg/1. TEST RESULTS: This well meets the requirements of the Municipality of Anchorage. THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceed this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. C~"J N S U LTIN G ENGINEER 203 W, 15th AVE "C' SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: {907) 279 3916 LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: Lot 4, Block 3, South Lakewood 6400 Woodmont Dr. ~,..... Herrin gt on / Es chbacher Single Family, Four Bedrooms /" Private, On Sit~ FROM MUNICIPAL RECORDS: TANK: Greer Steel, 1250 gal. Two Comp. ABSORPTION SYSTEM: Trench ABSORPTION AREA: 516 sq. ft. SOIL RAT1NG: 150 INSTALLATION DATE: March 1981 DATE OF LAST PUMPING: DATE OF TEST: January 25, 1988 TEST PROCEDURE: System was inspected and measured. Tank was found with four feet of cover and 50 inches of liquid. The clean out to the first compartment could not be found. The sump at the terminal end of the trench was found. Sump was 10 feet deep with a liquid depth of 6~ inches. The liquid in sump was heavy with sludge. Clean out at the beginning of the trench could not be found. 600 gallons of clean water was added to the sump while.the water levels in the tank 'and sump were monitored. Neither level rose. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage for a three bedroom house. The tank is sufficient for a four bedroom house, but the trench must be extended to meet the requirements for a four bedroom dwelling. NOTE The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants, unicip Anchorage P.O. B( 196650 ANCHOdAGE, ALASKA 99519-6650 (907) 343-4200 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES February 2, 1988 April K. Lee Fortune Properties, Inc. 3000 A Street, Suite 101 Anchorage, Alaska 99503 Subject: Lot 4 Block 3 South Lakewood Hills Subdivision Dear Ms. Lee: In reply to your letter, the Municipality would have no objection to the continued use of an existing septic system should the residence be destroyed. This would also apply to the upgrading or total replacement of such a system should it be damaged or rendered unusable in anyway. Of course, any new construction must meet existing code requirements as set forth in AMC 15.65. As we had discussed, there has been some concern as to lot size requirements under AMC 15.65.145.A. This requirement is enforceable on proposed subdivisions only and does not affect lots of record. I hope this will help clarify our position in this matter. Should you have further questions or need further clarification, please call this office at 343-4744. Sincerely~ Daniel N. Bolles On-site Services DNB/ljw~6 cc: Gus Andress, P.E., Manager On-site Services/Water Quality Northland Mortgage 440 West Tudor Road Anchorage, Alaska 99503 FORTUNE PROPERTIES, INC. 3000 A Street, Suite 101 * Anchorage, Alaska 99503 · (907) 562-SOLD (7653) January 29, 1988 Municipa~ity of Anchorage Department of Enviromental 825 "L" Street/Fifth Floor Anchorage, AK 99501 Qual i ty Re: Lot 4 Block 3 South Lakewood Hills Bear Mr. MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION FEB 1 t988 RECEIVED This is a written request for confirmation that the forestated lot, which is approximately 32,000 square feet, would be acceptable under current Municipalt~ ordinances for well and septic operation, as long as the size and capacity were large enough to accomodate the number of bedrooms, if the current existing structure were to be destroyed. I have attached an as-built survey by a local registered engineer for your information. I am not pos- itive as to the date this property was platted, but as you can see, it was before July of 1981. Thank you for your time and attention in this regard, your prompt response is appreciated. Respectfully submitted, April K. Lee encl/akl J~9'59' 00"£ /99.774/z~s.) ~/? ur/L° E~W~7;. · '~"O~.~C)-~ <~c.~ izl. 5 LOT SURVEY CERTIFICATION I hereby ce~tify th~ I have surveyed the property sttown and de~:.ribed LEGEND Date R. L. BUTTON IPegisterod Land Surveyor 519 W. Eighth Ave. Anchorage, Alaska 99501 Property of ½ · .. Prep~recl ~: (9o7)zlg-~poo . D~E RECEIVED TIM[: TIME DATE DATE DA~ ~UNICIPALI~ OF ANCHORAGI ~UNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ~ o~,~A~z, · .nw.o~n~A~..o~c~on mW~ON~,N~A~ a~o'r~o~  825 L Street- Anchorage, Alaska 99501 [',4AY 2 6 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED 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. PHONE PROPERTY OWN~..~~ . ~' MAILINGADD~ .~ (J PROPERTY RESIDENT (If different from above) PHONE PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION PHONE §, LEGAL DESCRIPTION TYPE OF RESIDE E NUMBER OF~BEDROOMS [] One [] Four · E FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other WATER~SUPP ~NDIvIDUAL* * 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 UTI UTY depth (attach log if available.) 8. SEWAGE DI~.OSAL SYSTEM YEAR o,-S,TE S STEM WAS ,,S ^LLED. INDIVIDUAL/ON-SITE** [] PUBL,O UT,L,TY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~INDIVIDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER -- E~Septic Tank or []Holding Tank Size: I~)-~~) If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorptio~ Area to nearest Lot Line 5. COMMENTS [] APP[IOVED FOR BED[lOOMS [] CONDITIONAL APPROVAL {letter must accompany certificate) [~ DISAPPROVED 72 010 (Rev. 6/79)