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HomeMy WebLinkAboutSOUTH LAKEWOOD HILLS #1 BLK 4 LT 2zf o-o©o q Jun 27 22 08:31 p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Department ® Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number. 015_ 151 .40 Date of Issue: Legal Description SOUTH LAKEWOOD HILLS #1 Block 4 Lot 2 Property Owner Name & Address: KRAUSE, ROBERT FREDERIC 6250 MICHIGAN BLVD. ANCHORAGE, AK 99516 Pump Installation Date: 06 - 24 - 2022 170 Pump Intake Depth Below Top of Well Casing: feet BERKELEY Pump Manufacturer's Name: B7P4JP07221-02 Pump Model: Pump Size: .75 hp 10 Pitless Adapter Burial Depth: feet MARTINSON Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? )< Yes :1 No Method of Disinfection: PELLETS Comments: Pump Installer Name: _ ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET Company: ANCHORAGE, AK 99518 907-243-0740 Mailing Address: City: State: Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Anchorage P.O. E i 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4::tkk 4 ? 4 4 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 9, 1987 Frederic R. Kraus 6250 Michigan Blvd. Anchorage, Alaska 99507 Subject: Lot 2 Block 4 South Lakewood Hills Subdivision On-site Sewer Permit Upgrade ~860375 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1986. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report (three part form) must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4744. S in c~e~pe 1 Y~/ Program Manager On-site Services RWR/ljw eric: copy of permit Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: (ENGINE~ ['S SEAL) LEGAL DESCRIPTION: .~o~,¢1, ~,~e ...... / ////,; /~z/~ L ,~. Township, Range, Section: 1 2, 3- 6- 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS ,~C,/ /;~" ~/ /o id WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN IF YES, AT WHAT DEPTH? Monitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop t/2V _ d,J~ /15'7 30 ¢ ~ , ~ ¢ 122¢ - PERCOLATION RATE / ~'/' ~ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN g/ ~''~ FT AND 5-- FT PERFORMED BY; /~g(: ~ I ~ '¢'¢"*' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES INEFFE T~T ON THIS DATE, DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: (*,r~'~,~l . . DATE PERFORMED: (ENGIN~ 22 5<> /?b) 6' LEGAL DESCRIPTION: ,~;, .M. Z¢./z,.,~,.~,,,,,/ //~yl5 /'~ ~ ~. ~.. Townsh p, Range, Section:%,~ ~s-- T/~,'~ ~' 1 2 3 4 5- 6- 7- 8- 9- 10- 11 13- 14- 15- 16- 17- 18- 19- 20- SLOPE SITE PLAN COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT monitoring? , Gross Net Depth to Net Reading Date Time Time Water Drop /2~0 ~'0 q. qq i3' PERCOLATION RATE /~'' (; (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3~/Z FTAND ~ FT PERFORMEDI]Y: /J;~-E.% _ ~ ¢-¢~ -/// /9¢~.~-'~' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES INEFFEC ON ~HISDATE, DATE: 72 008 (Rev. 4/85) ALASKA ENVIRONMENTAL CONTROL SERVICr INC. 1200 West 33rd Avenue. Suite B ANCHORAGE:. ALASKA 99503 (907) 561-5040 SHEET NO OF CHECKED By DATE GP~:~.TER ANCHORAGE AREA BOROIIGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION /~'i;~,(4 "' /-'/ 4~:;z- /-([)/ [) SEPTIC TANK: ADDRESS ! .) '(: ':~ 1. ~ f, / ~ PHONE DISTANCE FROM WELL LIQUID CAPACITY ~ .) MATERIAL_ (!~)/~'jC'(' ' NUMBER OF · ~.- t' ]. .COMPARTMENTS OALLONS. INSIDE LE~GTH~ INSIDE WIDTH LIQUID DEPTH ~__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS i OUTSIDE DIAMETER "~ OR WIDTH ~, ~ LINING MATERIAL .I (. ,~ ,~ ¢ j~.i( )i i"_//~'/(:~ ";~ DISTANCE FROM WELL I. ~ NEAREST LOT LINE &. ,t TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) _, LENGTH ;? ¢(/ , DEPTH · BUILDING FOUNDATION [[ ¢~i(.~ ~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LIN~_ ABSORPTION AREA TOTAL LENGTH FOUNDATION NEAREST LOT LlixLE..-"-"% . OF LINES ~ .,-'0' STAN ES - -~'"ERENCH WIDTH N. TOTAL EFFECTIVE SQ, FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FIN SH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE_ N ABOVE TILE WELL: Typ~'()jlJ:~ ~ c'i) DEPTH i('" NEAREST SEPFIC LOT LINE ~': 'f SEWER LINE ' ,TANK DISTANCE =ROM WATER · BUILDING FOUNDATION - ''~' ~' SAMPLE · SEEPAGE 'o -~ . SYSTEM ( ~ ~ CESSPOOL NEAREST OTHER SOURCES DISTANCES: · ' I0 :' '~ ; ;,1:', -,, , DIAG RAM OF SYSTEM r DATE APPROVED GREATEr'\NCHORAGE AREA HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 L(~ -'qROUGH cas. No.'':'dC:/ 279-2511 · v~. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT ½:? ~¢~ /P ~;~-~&MA L Nfl ADDRESS /'~ NAME OF APPLICANT_~ ~,,'~ ..,~,, .... ~ RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH ;,: d ~< ~ / TO BE INSTALLED BY_ PERCOLAT ON TEST RESULTS .,~ ~( . F~, ANTICIPATED DATE 0F COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT Ac, ....PHONE LOCATION OF INSTALLATION ,:,,~:~ ~V ~ SEEPAGE PIT ~, , DRAIN FIELD , OTHER THIS IS TO SERVE AS ? ~ , /' ~P~:,,>,,;/;', RMITTO INSTALLA ASDESCRLBED BELOW. SIZE OF UNIT TO BE SERVED . SEPTIC TANK SIZE/ TYPE ~' <": J'W(J ~ ~ SEEPAGE AREA DIAGRAM OF SYSTEM DISTANCES: t'~.~ , ~ l_ " I certify that I am familiar with the requb'emcnts of Greater Anchorage Area~ Borough Ordinanc/e No. 28-68 a.n,d that the above described system is in accordance with said code. i~.) (',.?i \,,,j ~h ~ ~ ~'~) ~)/ ~)C~ ~?~-?" ~' REATER ANCHORAGE AREA BOROUGU HEALTii DEPAkTMENT 327 EAGLE STREET ANCHORAGE~ ALASKA 99501 This Fc:'m ,',a~o2,ts a: So~]s Log / rercozaz~,on Tes1~_ _ Depth i'ee~: Soil ~.hap~e,. zstzcs Location Sketch Was Ground Water Encounte~,ed?~/~J,_~;Z,~ if Yes~ At What Depth Reading Date Gross Time Net Time Depth To H20 Net DPop Proposed Instal~Seepage Pit L/~- Dr ' r. De th Of f . . ' ..~z~-~-_---~,~--.--~-~ azn ~ ~e.ld P , Inlet De0tn To ' ,,~ - ........ COMMfTf4~. zz ~ ~ Bottom Of P~t Or Z~.ench //, Test Performed B : ~ / , Data Certified By: ¢2 M~?cr ~7OO Br~w F.O. ~ox Anch~r~, AK 995 ~9-6650 Pump Installation Log Well Drilling Permit Number: SW . Date of Issne: __ parcel Identific.~fion Number:__ pifless Adaptar Burbd Dep~: feet ! Property O~vuer Nam~ & /¢9,50 .aLi c~h'~ o,.cr, ,'~\~'d- Pump Installer • Municipality Anchorage 11'71i. t{Ifii t� of � � �� alp:,�I •i 1_ On-Site Water&Wastewater Program j �N11 iJ pr•,r_,! (907)343-7904 c'l � CERTIFICATE OF ON-SITE SYSTEMS APPROVAL DO ' kiv Parcel I.D. • = • Expiration Date:-J - 1. GENERAL INFORMATION Complete legal description SOUTH LAKEWOOD HILLS#1;BLOCK 4,LOT 2 Location (site address) 6250 MICHIGAN BLVD.'ANCHORAGE,AK 99516 Current Property owner(s) CHELSEA&ROBERT KRAUS Day phone 229-8197 Mailing address 6250 MICHIGAN BLVD.'ANCHORAGE,AK 99516 Real Estate Agent BRENDA REYNOLDS Day phone - 2. TYPE OF DWELLING: II Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) • 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well U Individual On-site U Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well 0 Community On-site 0 Public Water System ❑ Public Sewer ❑ WaiverNariance request for. N/A Distance: - Received by: Date: 4V/P COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee$ J /D Waiver Fee$ Date of Payment 1/3L 1 "�t Date of Payment Receipt Number 111 I O6 Receipt Number COSA# O.��-1 f DD0 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are)safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E.TUDOR ROAD,SUITE 101 *ANCHORAGE,AK, 99507 Engineer's Printed Name JEFFREY A.GARNESS,P.E. Date 121/1 , /i q- Engineer's Comments: In conducting this evaluat on,GEG provided an engineering evaluation of the well and/or septic system in accordance with the ��V�‘�� guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results desmbe the t4 OF (^1144 condition of the systemrs on the date/s of the evaluation.Separation distances were measured to readily identifiable features 4,•.,<c>,....� `� 4 1♦ Hidden defects orerrooachmentsmay exist that were not identified during the evaluation.lheoperational life ofall we&and septic •••••""••• ••.. systems depend on a varkty of variables including,but not limited to,soilcondltans groundwaterlevels(that may fluctuate during � •• ' • q •1 the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system's These ,•• •• \*�* conditions can vary,and are outside the control of GEG.Satisfactory fest results do not guarantee future perfon mane of the i 4 \ 0 system's;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. , / GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the / i ; current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the ! r A Ga ess 114'5: information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not # C •. E-79 ,.4/ar authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. • f 6. DSD SIGNATURE �*'1 PROFESS' ,,4• LICENSE ���t""��� System#1 Approved for bedrooms. #LICENS 4 System#2 Approved for bedrooms. Disapproved. ��NY OF 'G�Q� 'Qi�r�; Conditional approval for bedrooms,with the following stipulation �O ::.,•,. ON-SITE � . WATER AND m WASTEWATER o �`�' PROGRAM rc,�sERVIGc:— .. By:-.------- ( AA--- (`- 41. Original Certificate Date: 1' 3 - The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10/12/12) If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: SOUTH LAKEWOOD HILLS#1: BLOCK 4, LOT 2 Parcel ID: 015-151-040 A. WELL DATA *PER 11/3/10 PUMP INSTALLATION LOG BY ARTIC WELL AND PUMP Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1970 (?) Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *178+ ft. Cased to UNK ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 11/8/17 G Static water level \.- ft. 108.3 ft, ' NO Well production g.p.m. 1.8+ g.p.m. WATER SAMPLE RESULTS: Coliform N colonies/100 ml. Nitrate ND mg./L. Collected by: GEG, Ltd. Ansi-oLJ P v^+P Arsenic: < 5.0 ug./L. Date of sample: 11/8/17 1Zit L}. I 0- L��L, Se—Sz.nt� B. SEPTIC/HOLDING TANK DATA *DOUBLE CLEAN-OUTS BEFORE TANK Tank Type/Material SEPTIC/CONCRETE Date installed 5/29/70 Tank size 1250 gal. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 10/26/17 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE AT MONITORING TUBE Date installed 5/29/70 Soil rating (g.p.d./ft2or I %bdr)) 225 System type SEEPAGE PIT Length 24 ft. Width 26 ft. Gravel below pipe 9 ft. Total depth *13.08 ft. Eff. absorption area 900 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 12/5/17 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 88 in. Water added 753 gal. New depth "106in. Elapsed Time: 122 min. Final fluid depth ***97 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) ****NONE KNOWN If yes, give date - • FOUND NO EVIDENCE/INDICATION THAT THE TRENCH PERMITTED FOR INSTALLATION IN 1986 WAS INSTALLED • **CRIB WAS FULL AFTER 753 GALLONS. SYSTEM WAS 83% FULL PRIOR TO THE START OF THE TEST • ***SYSTEM 91.5% FULL • "'"SEE ATTACHED EMAIL FROM HOMEOWNER D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off"level at •• •• a er alarm level at in. P- •• Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 501+ On adjacent lots '100'+(WITH CAVEAT) Absorption field on lot 1001+ On adjacent lots '100'+(WITH CAVEAT) Public sewer main 75'+ Public sewer manhole/cleanout 1001+ Sewer/septic service line 26+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 101+ Water service line 10'+ Surface water 1001+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 101+ Water service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 'SEPTIC TANK AND DRAINFIELD NOT FOUND ON SOUTH LAKEWOOD HILLS#1;BLOCK 3, LOT 6 _svisusilik II_ 4.4.7 OF •�!. G. ENGINEER'S CERTIFICATION x ...•• "'� ,p•. /\ If I certify that I have determined through field inspections and 4�• '; •„ • review of Municipal records that the above systems are in • conformance with MOA COSA guidelines in effect on this •` ��� • date. ;1 o f -,/.A. Garne5s :if i i Engineer's Printed Name JEFFREY A.GARNESS �!s, • E-17953) �_� / l �jF.Q '...12I .t � . Date ( Z! 21/r`�' ,��0 _ ..........1 P�,�4• LICENSE ,iit:�,OESS �4• *AECC884 vas"� (Rev.10/12/12) I MICHIGAN BLVD. N 89 59' Vd 190.00 I I x 1 0 0- I i y OAEII / 1 I 1 E IIs ',4, LJ 0 LW w C MI I - 1 5 �� ,000Op�4 T i 45 ./ OF q t9 1111111,10 Z i & s.... `s 00 ° I o�;• 49 Ill* * 0D S/ry cc 1 0 �~ �R�F Fq m! S/m it f�'`�' D gMFNM/0y 1 �v . • : o� 06SF4°°°%°°°°00° QIti°%; SHANE A. HOLT .' $ I Q LS-6914 . ���0 44r°fessiona‘ �o� s i �DO000�� I K° AS-BUILT(SURVEY 1" = 20' o NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY 41111111 ; OF THE FOLLOWING DESCRIBED PROPERTY lilli LOT 2, BLOCK 4, SOUTH LAKEWOOD HILLS SUB. , FIRST ADD'N. - ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE N 89 59' W 190.00 5'"""" =_A=F"'"" VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY DATED AT ANCHORAGE,ALASKA THIS _20TH DAY OF CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOVEMBER , 2017. NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. ..--