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SOUTH LAKEWOOD HILLS #1 BLK 3 LT 4
Onsite 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 WOODMONT DRIVE 0 M 0 co JGG "If'f�r11 Inc ORDERED BY: WES SAUNDERS 250 H Street Anchorage, Alaska 99501 Survey Department Phone 562-5291 Mainline Phone 243-8985 AECC 668 LEGAL AS -BUILT DESCRIPTION: LOT 4, BLOCK 3, SOUTH LAKE WOOD HILLS NO. 1 SUBDIVISION DRAWN DATE: 2/4/2019 WORK ORDER: 19002 N890 59' 00"W 200.00' 30' CHECKED BY: SC GRID: SW2638 SCALE: 1" = 40' FB/PG:812/43-44 REF: 011_474 3 SEPTIC STAND 2 SEPTIC STAND PIPES PIPES 39.7' 1630 o : CO 18.0 O 10.0' p co LOT 3 `� EXISTING 11'6. 26.0' �r LOT 4 ,; ;: o 8.0o HOUSE r. o C) r :.. .- 3.0' o Q o 46.91 o 0 O 0 Z ;. Z C oo004p0 OF A 16.2'48.4' � M - o • � � � EXISTING zo .. .. M GARAGE 48.4 M . 49TH �O Qr66�N7Ek_ 13.0 10' UTILITY EASEMENT 30 NOTES: • • • • •: 'i N890 59'00"W 200.00' 1. SNOW AND ICE MAY CONCEAL MINOR STEVEN CALLAGHAN.- 0Q SURFACE FEATURES. Q se , LS -12034 , ° J�QQ� �4 0?�a oOWITHOUT prof LOT 7 LOT 8 THIS DRAWING SHALL NOT BE 2 MODIFIED FOR USE AS A PLOT PLAN THE EXPRESSED WRITTEN �-°© essiona� o CONSENT OF LCG LANTECH. JGG "If'f�r11 Inc ORDERED BY: WES SAUNDERS 250 H Street Anchorage, Alaska 99501 Survey Department Phone 562-5291 Mainline Phone 243-8985 AECC 668 LEGAL AS -BUILT DESCRIPTION: LOT 4, BLOCK 3, SOUTH LAKE WOOD HILLS NO. 1 SUBDIVISION DRAWN DATE: 2/4/2019 WORK ORDER: 19002 DRAWN BY: AS PLAT: P-611 CHECKED BY: SC GRID: SW2638 SCALE: 1" = 40' FB/PG:812/43-44 REF: 011_474 LEGEND: ADDRESS: 6400 WOODMONT DR. PARCEL M 015-151-17-000 SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. Gravel SEPTIC STANDPIPE OS EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE Concrete: WATER WELL :;: EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY 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 Deck ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181390, Rebecca Carroll, 10/30/18 MUNICIPALITY OF ANCHORAGE ►f c7p DE FITMENT OF HEALTH AND HUMAN SER ES V f L� Al Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES Address FROM TO SEPTIC ABSORPTION WELL TANK FIELD (� G. `�� � �`•v �yrq �'"t {��i Y r WELL Phones Permit No. No. of Bedrooms ,Oso LEGAL DESCRIPTION LOT LINE Lot Block Subdivision _ ✓ FOUNDATION Township, Range, Section 7 7— / aAS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, Ctl driveway, water bodies, etc.) TANKS I I I I I I I I ITT— ❑ SEPTIC ❑ HOLDING Manulacturer Capacity in gallons Material No. of Compartments TYPE OF SYSTEM TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade original grade FT 0 FT Fill added above original grade Gravel depth beneath pipe FT FT Gravel length Gravel width FT FT Total absorption area Distance between lines /y SO FT I FT Number of lines Soil rating Pipe material /r;v SQ FT AS714 f" YC Installer / 7 Date Installed -7/7 199' C N t rii pf&,- o ELLS El PRIVATE PE T083E OTHER (Identify) Classification (A,B,C) Total Depth JCased to FT FT I Installer [REMARKS: Date Installed: , fit gecz 6 E)0.571_141167 1-J iJ A_ 11ZI - S Sir � .E■■■■■MB■ SOMENZEMEN NOWNEEMMEE Imm ENMENAMEMW �►�.- NEON Emmed W ■■■■■■ENC scale: I N a &d Inspections Performed by: 7- 5 Date: .1171kk- ��v••— — •— certify that IN was performed according to all Municipal and State idelines in effect nn this date: , L�7 Health Department Approval: Date: —J�;Q 72-013 (3/85) ENGINEER'S SEAL r - . 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$CHBACHER SEPTIC SYSTEM DESIGN DATE, FE~, ~ 1988 SHEET,/ GR]D~B638 q.g ld'O ,,. 7 MUNICIPALITY OF ANCHORAGE C DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �T 46 PHONE ❑ i1PGRADE MAILING ADDRESS / LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS UY F- ZQ LU � Well Absor^* DISTANCE TO:-�� Manufacturer Q(�� G C Dwelling ( PERM O �jp Materials-.� No. of compartment$ yL_� y Liq, /gagacity in gallons �{ � IF HOMEMADE: Inside length Width Liquid depth Y JUZ DISTANCE TO: Well Dwelling PERMIT NO. _ FQ- Manufacturer Material Liquid capacity in gallons o w = DISTANCE TO: Well 1� R, F Foundationj60 Nearest lot line PERMIT NO.Y/ 4 j C� LL z FZW No. of lines Length of e c irjp Total len thof Jines ( Trench the ' �jinches Distance bey li ; 9 F O Top of tile to finish _gra de Material eneath tile /70,51—inches Total effec.i bsorption area w C7 Length Width Depth PERMIT NO. da w Type of crib Crib diameter Crib depth Total effective absorption area LU DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE ATTEERIALS SOI L TEST RATING 16Z INSTALLER �LG1`/ 71 OF REMARKS APPROVED DATE LEGAL /l-UIJ (Hev. J/%ti) 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 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251010 Parcel ID 015 -151-17 Expiration Date: 9/27/2025 Legal description SOUTH LAKEWOOD HILLS #1 BLK 3 LT 4 Site address 6400 WOODMONT DR Current property owner(s) SAUNDERS WESLEY E & CYNDI L X The On-site system(s) is/are approved for 4 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 2/26/2025 Thr��C'rtificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sys`tem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE CDevelopment Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section �' Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-151-17 Complete legal description Location (site address) South Lakewood Hills #1 Block 3 Lot 4 6400 Woodmont Drive Current property owner(s) Wesley E. & Cyndi L. Saunders Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: *1 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 6 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Field to lot line Expedited review requested: ❑ Distance: 2.9' By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5-5-0 Date of Payment iKl2y COSA # 0.5 C Z s l o/ Waiver Fee $ 1 2 Date of Payment l �t `f A Waiver # OS V Z S-/000 COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS G.CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC & MOA 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 Phone Engineer’s Printed Name Date Municipality ®f Anchorage Dejul tmrnr P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 (+ Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV251000 COSA#:OSC251010 Permit#: PID#: 015-151-17 Legal Description: South Lakewood Hills #1 Block 3 Lot 4 Engineer: Pannone Engineering Services 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. Waiver is Granted: X Waiver is not Gran l Date: Approved b . C- ame of Revi er--- **** VARIAN C E/WAIVER REVIEW **** Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com Mailing: P.O. Box 1807, Palmer, AK 99645 Telephone: (907) 745-8200 FAX: (907) 745-8201 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska Subject: South Lakewood Hills #1 Block 3 Lot 4 Lot Line Waiver Request Ladies and Gentlemen, We request a separation distance waiver for an existing absorption field to lot line of 2.9’ feet. This is an existing drain field that was installed on 03/24/1981 and extended onto on 07/07/1988. In existing configuration this drain field does not encroach upon any existing surrounding wells or septic systems on neighboring lots. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. If you have any questions or concerns, please contact me at 907.745.8200. Sincerely, T S Steven R. Pannone CE 8149 TH49 G NI E K A I R E G LSSIAONROFPD E E NR E E ER S F ALATSATEO Steven R. Pannone, P.E., F. ASCE Owner/Civil Engineer 10 January 2025 700 W 41st ave Suite 201 Anchorage, AK 99503 (907) 345-1890 info@aplusak.com Invoice DATE 01/10/2025 INVOICE#7401 TERMS Due Upon Receipt DUE DATE 01/10/2025 BILL TO Wesley Saunders 6400 Woodmont Dr Anchorage Alaska 99516-1890 (907) 830-8818 SERVICE LOCATION Wesley Saunders 6400 Woodmont Dr Anchorage Alaska 99516-1890 (907) 830-8818 JOB#DATE PO/REF#DESCRIPTION 1057600427 01/09/2025 Excavate and repair the cleanout at the end of the field. Pannnone wants to be present during this repair. Excavate tank inlet and outlet to verify adequate drop and integrity. Use a camera to verify the baffle integrity. *50% deposit required prior to the start of commencement of work, remaining balance to be paid upon completion. Inclusions: Jetting drainfield from the repair Pumping system down if needed Exclusions: Ground thaw unit. (can be provided at additional expense) If you have any questions or concerns, please do not hesitate to call our office at the number listed above. We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. Pricing is subject to change in the event of unforeseen circumstances such as but not limited to ground water influx gravel and or sandy soils causing the hole to collapse. If one of these events occur the customer will be notified and charged an hourly rate of $250 until event is remedied. A 5% per handling fee will be charged if paying by credit card (we accept all major credit cards), and a monthly 3% finance charge will be added to all past due invoices. Completion Notes: 1/6/25 Excavate and repair cleanout at end of drainfield. Drainfield pipe had 2 inches of sludge, recommend jetting line. Backfill with native material 1/8/25 Jet line with help of Artic Influence and pump truck. Tv'ed drainfield and all sludge was removed in process, 1"-2" rock observed still present in pipe. Pump truck hose too small diameter to retrieve. Tv'ed existing septic tank and baffle was still in place PRE-WORK SIGNATURE POST-WORK SIGNATURE 1 12/23/2024 03:55 pm Signed By:Wesley Saunders Signed By: CUSTOMER MESSAGE We now accept payment online for pumping jobs at WWW.APLUSAK.COM Please just type in amount on invoice and we will mark as paid once payment is processed. Thank you! * We are not responsible for any damage to driveways, walkways, and or pavement due to soft ground, poor installation, or slick/icy conditions. Late Fees May be applicable after 30 days past due. Invoice Total:$4,955.00 Deposits (-):$2,477.50 Payments (-):$0.00 Total Due:$2,477.50 2 700 W 41st ave Suite 201 Anchorage, AK 99503 (907) 345-1890 info@aplusak.com Invoice DATE 02/06/2025 INVOICE#7479 TERMS Due Upon Receipt DUE DATE 02/06/2025 BILL TO Wesley Saunders 6400 Woodmont Dr Anchorage Alaska 99516-1890 (907) 830-8818 SERVICE LOCATION Wesley Saunders 6400 Woodmont Dr Anchorage Alaska 99516-1890 (907) 830-8818 JOB#DATE PO/REF# DESCRIPTION 1059641747 02/03/2025 **This estimate is for septic repair only, not for driveway repair** We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. If locates indicate utilities are in close proximity or cross the excavation site and require additional caution and labor to hand dig in the area, an additional charge will incur based upon labor hours and difficulty. Pricing is subject to change in the event of unforeseen circumstances such as, but not limited to, unearthing unexpected items such as undocumented tanks or old cribs, ground water influx gravel and or sandy soils causing the hole to collapse or any event causing less than ideal work conditions. If one of these events occur the customer will be notified and charged an hourly rate of $250 until event is remedied. In the circumstance in which a special provision is needed in order to remove a fence, tree, deck, stairs, shed or other obstruction near the excavation site, additional charges for contractors as well an administrative fee will be added. A+ Home Services is responsible for contacting the needed contractors unless otherwise specified in a written agreement with the homeowner. We will do our best to coordinate their schedule with the needs of our company and work with the homeowner for any scheduling conflicts, however, this may not always be possible, dependent upon specific job needs. We reserve the right to discontinue work if change orders are not approved in a timely manner. If work is discontinued or delayed for any reason, we may charge additional fees until delay is resolved. If you have any questions or concerns, please do not hesitate to call our office at the number listed above. **THIS IS ONLY AN ESTIMATE** Job pricing may change upon completion due to price increases from vendors or change of scope on the project. We will do our best to keep in communication as changes occur. A 5% per handling fee will be charged if paying by credit card (we accept all major credit cards), and a monthly 3% finance 1 charge will be added to all past due invoices Completion Notes: 2/3/25 Set up ground thaw equipment for driveway excavation 2/4/25 Fuel ground thaw equipment. Remove hoses and blankets Excavate approx. 6-8" down to frozen ground Replace hoses and blankets 2/6/25 Excavate for start of drainfield. Locate existing cleanout and repair. Backfill w/ native material. Will need a regrade in Spring PRE-WORK SIGNATURE 01/29/2025 10:07 am Signed By:Wesley Saunders POST-WORK SIGNATURE Signed By: CUSTOMER MESSAGE We now accept payment online for pumping jobs at WWW.APLUSAK.COM Please just type in amount on invoice and we will mark as paid once payment is processed. Thank you! * We are not responsible for any damage to driveways, walkways, and or pavement due to soft ground, poor installation, or slick/icy conditions. Late Fees May be applicable after 30 days past due. Invoice Total:$6,590.00 Deposits (-):$2,955.00 Payments (-):$0.00 Total Due:$3,635.00 2 WOODMONT DRIVE — 0 0 N89° 59'00"W 200.00'30' 3 SEPTIC , 2 SEPTIC STAND STAND PIPES PIPES 39.7' I 16,31, 0 o a o o °7 0 0 8.0' 16.0' o r10.01, o GRAPHIC SCALE LOT "' EXISTING 10 26.0' I $-0'v HOUSE 1 20 40 o LOT 4 M o 3-0' o p 10 46.9' ", in O CD o v o 0 1 " = 40' o0 0 z z < Im 16.2' 48.4' � EXISTING A����� �,�Q.• , } M GARAGE M G)•• 9 } 48.4' *.-'49 ' 49TH. * ! CONEX -- T13.0� 30' I 10' UTILITY EASEMENT N89° 59' 00"W 200.00' `9 ARY RVELIS 82 LOT 7 LOT 8 • 4a�� 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 LEGEND: YI=Ch"'� Mainline ..rte � Inc DRAWN DATE: 2/21/2025 WORK ORDER: 25006 Gravel Phone 243-8985 SEPTIC STANDPIPE QS " AECC 668 DRAWN BY: AP PLAT: P-611 Concrete...- WATER WELL Or" CHECKED BY: GMG GRID: SW2638 FENCE XX— —=Ov[rho ORDERED BY: WESLEY SAUNDERS SCALE: 1" = 40' FB/PG:812143-14 REF: 01 L474 Wo.'r Deck NOTE: 1) THIS MORTGAGE LOCATION SURVEY (AS -BUILT) WAS PREPARED FOR WESLEY SAUNDERS, IT SHOULD ONLY BE USED FORA SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS FOR ADDITIONAL USES LATER WITHOUT THE EXPRESS WRITTEN CONSENT OF LCG LANTECH, INC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. 2) THE LIABILITY EXTENT OF LCG LANTECH, INC. SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION FOR THIS PRODUCT, UNLESS GROSS NEGLIGENCE IS DISCOVERED. 3) THIS MORTGAGE LOCATION SURVEY (AS -BUILT) IS A REPRESENTATION OFTHE CONDITIONS THAT WERE FOUND ATTHETIME THIS SURVEY WAS PERFORMED. THIS AS -BUILT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4) THE INFORMATION CONTAINED ON THIS DRAWING SHOULD NOT BE USED IN SUPPORT OF ANY NEW CONSTRUCTION. 5) THIS AS -BUILT ONLY SHOWS EASEMENTS THAT WERE ON THE ORIGINAL PLAT. IT IS THE PROPERTY OWNER'S RESPONSIBILITY TO DETERMINE IFTHERE ARE OTHER EASEMENTS, COVENANTS, RESTRICTIONS, OR RIGHT OF WAY TAKINGS OF RECORD NOT SHOWN ON THE ORIGINAL PLAT. 6) SURFACE FEATURES MAY HAVE BEEN COVERED BY SNOW AND ICE WHEN THIS AS -BUILT WAS PERFORMED. ADDRESS: 6400 WOODMONT DR. PARCEL #: 015-151-17-000 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)