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SOUTH LAKEWOOD HILLS #1 BLK 4 LT 6
South Lakewood Hills #1 Block 4 Lot 6 #015-151-38 Municipality of Anchorage .� Development Services Department e Building Safety Division : ^_• — ' _ On -Site Water & Wastewater Program, 4700 South Bragaw St. , P.O. Box 196650 Anchorage, AK 99519-6650 www.ei.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW030012 PID Number: 015-151-38 Name:JACKIE REPP Wastewater System: ❑ New ■ Upgrade Address: 6251 EAST 112TH AVENUE + ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 742-3603 4 O Deep Trench ■ Shollow Trench ClBed O Mound 13 Other LEGAL DESCRIPTION S°' "°""° 3.0 Total Depth from anpinol gods: 4 MAX GPD GPD/Sq. R R Block: Lot: Subdivision: Depth to pipe bottom from anginal graft Crawl depth beneath pip,: 4 6 SOUTH LAKEWOOD HILLS #1 1.49 MAX R 0.5 rL Township: Range: Section: FIN added above orglnd grade: Gravel length: – – – SEE DWG R 42 R WELL: ❑ New ❑ Upgrade Gravel width: 5 Number of Snee: 1 Distance bel~ Ince: — R R ClaeeRkatlon Private, A.e.0 . Total Cored To: Total obeorptlon area: Pipe material: R I R 210 SO. R D 3034/ F-810 SCH 40 PVC staao water lord: Installer. A+ HOME SERVICES Date Feta 1%29-30/2003 orvlr. Date Drilled: R Yield: Pump Set At Cos" Hdght Above Ground TANK CPM R R SEPARATION DISTANCES aseptic °Holding ■S.T.E.P. °other To Septic Absorption Lift Holdingbge/Pfivb Manufacturer. ANCHORAGE TANK Copaalty F gallons: 1500 From Tank Field Station Tank sewer un« Well 1009+ 100'+ too'+ – 25'+ FIBERGLASS W_n of eor" • 2 Surface water 100'+ 100'+ 100'+ — — LIFT STATION Lot Une ' 5'+ 10'+ 5'+ – – Size F gallons: 1500/74 Manufacturer. ANCHORAGE TANK ORENCO SYSTEMS Foundation 5'+ 100+ 56+ — — ump on level oC mp level at: High water alarm at: 1 42" 27.5" 42-/16.5" 46"/37" Curtain Drain NONE KNOW Pump Mow t Model: Electrical brpect om performed W. 420 OSI 05 HHF M.O.A. Remarks: "THIS IS AN ADVANTEX TREATMENT SYSTEM BENCH MARK Location area Deearlption: "THE EXISTING DRAINFIELD AND SEPTIC TANK BOTTOM OF BACK DOOR THRESHOLD WERE COMPLETLY ABADONED PER UPC Aew,med Elevation: 100.00 R ENGINEER'S SEAL 0Q X=`�.. � 0 .S 40 o Inspections performed by: AKWWC, INC. Dates: 1st 1/29/2003 2nd 1/29/2003 .... ............. 0 3rd 1/30/2003 y am ss;• Developmentices a art ret Approval 04�,. •, E 79 �Op°dPnod Reviewed and approved by:/—Date: to d3 o� (Rev. 12/01) �Ofess7o 0 QQ�O��p'd PERMIT NUMBER: SW030012 I I ( I I A I S I DBL1 33.96 46.69 DBL2 34.58 47.26 ST1 37.00 49.27 POD 40.67 51.88 MH1 45.48 55.46 45.48 55.16 EMTJMT2 62.56 85.26 _ _5 A 82.82 70.36 AS -BUILT DRAWING , • � y EXISTING WELL I �\ I \ I NEW DRAINFIELD \ i UTILITY EASMENT— _ _5 A A+ DID NOT INSTALL A �-- ,jI.T2 FOUNDATION CLEANOUT. LR— 1jl��172 INSTALLED DOUBLE AT TANK. ICLEANOUTS I MH H I SHED ST NEW 1500 GALLON ADVANTEX TREATMENTISYSTEM BL1 B t EXISTING / 4 OM i>• HOUSE\ b E. 112TH AVENUE _ 2/3/2003 .. .. _. _._.,........ _ . " o� .. . ' - DRAWN BY: ALASKA NN'ATER & AVASTEWATER C.J.G. CONSULTANTS, INC, Ste` 6901 DEBARR ROAD. SUITE 28 • ANCHORAGE. AN 9950E • PHONF. (907)357-0179 •FAX (907)338•32L6 1'• = 40' PREPARED FOR: PHONE NUMBER: PACE NUMBER: JACKIE REPP (907) 742-3603 2 OF 3 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS SUBDIVISION #1; LOT 6, BLOCK 4 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE PARCEL ID 015-15 MIA I: r % j �mm y.Gar ss. Et' 3 \ Q` , • � y EXISTING WELL 2/3/2003 .. .. _. _._.,........ _ . " o� .. . ' - DRAWN BY: ALASKA NN'ATER & AVASTEWATER C.J.G. CONSULTANTS, INC, Ste` 6901 DEBARR ROAD. SUITE 28 • ANCHORAGE. AN 9950E • PHONF. (907)357-0179 •FAX (907)338•32L6 1'• = 40' PREPARED FOR: PHONE NUMBER: PACE NUMBER: JACKIE REPP (907) 742-3603 2 OF 3 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS SUBDIVISION #1; LOT 6, BLOCK 4 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE PARCEL ID 015-15 MIA I: r % j �mm y.Gar ss. Et' 3 \ Q` PERMITNUMBER: DRAWING PARCEL ID NUMBER: SWO30012 SWO AS -BUILT 015-151-38 TOP OF ADVANTEX POD TOP OF MANHOLE FINAL GRADE � 98.15+ + 99.09 (AVG.) 99.84 (AVC.) --� \\ TOP OF MANHOLE + 98.77 (AVG.) --,, INVERT OF OUTLET - 93.89-7 .-94.15 OF TANK I 1 rl ■ nIM.- 1 1 INVERT OF PIPE .f93.29 TH#2 wr ORIGINAL GRADE I I 1 I - AS t6 TOP OF SAND - 93.46 (AVG. RELATIVE ELEVATI OF GROUNDWATER IN TH;l a 88.66 RELATIVE ELEVATION OF GROUNDWATER - 85.66 UTNE ELEVATION OF BOTTOM OF TESTHOLE - 83.46 P OF TANK - 94.08 INVERT OF INLET - 93.73 BOTTOM OF UFT VAULT - 90.56--. FINAL GRADE - 96.24+ FABRIC ORENCO PUMP VAULT -THE LINE IS 1.25 INCH SCH 40 PVC WITH 1/4 INCH HOLES FACING DOWN EVERY 24 INCHES. (21 HOLES TOTAL) INVERT OF PIPE - 93.97 (AVG.) -BOTTOM OF TRENCH - 91.46 (AVG.) 2/11/2003 �i i Y[ � ' .►� s DRAWN BY: QO ' • • 4� ALASKA. `VATER & WASTEWATER C.J.G. oo-. 4 I y�� CONSULTANTS, INC. SCALE: 0 • 901 DEBARR ROAD, SUITE 2B •ANCHORAGE. AK 99504 • GHONF. (907)117.6179 • FAX (907)118.1246 N.T.S. �............. I. ..... BARED FOR: PHONE NUMBER: PAGE NUMBER: O JACKIE REPP (907) 742-3603 1 3 OF 3 e r y A. am s :AL DESCRIPTION: 79 e�G SOUTH LAKEWOOD HILLS SUBDIVISION #1; LOT 6, BLOCK 4, Q �E OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE �40`Ofp'a�O� o 400000 Fi E -§-�QP3_ Q4.4ZP FRAM ft FIn SERU1U:5t , IFL907-868-6770 _ , _ TQ: 3383246 P _V .. RightFAX 2/6/2003 5:26 PAOE 1/1 RigbtFAX Inspection Report Municipality of Anchorage, building Safety Division 4700 South Dragaw INSPECTION: VOICE 343.8300 INSPECTIONS FAX C907)249-7777 INFO: 343-7002 Name ED'S E;ECTRIC Permit 03.7219 Adch Legal subdivision COinh*nts or Directions 6251 E 112TH AVE OK4LT6 SOUTH LAKEWOOD HILLS *1 Phone 272-4591 Inspection Date 2/6/2003 AM AM***CALL B4 FOR SITE MEET}*+UFT STATION Inspection Retro Eledrical Relnspectlon N No NONCOMPLIANCE OBSERVED 0 CORRECTIONS ESSENTIAL AS EXPLAINED BELOW WILL RE-EXAMINE AT NEXT [} DO NOT.CONCEALUNTIL REINSPECTION INSPECTION COMMENTS: (for Inspector use only) LI..E[,1/ r► Foil Inspector ,J.��2_.,. Date.. 1_--/ Iv :i CC0-r-_�MrA7 TLA I rAA.[VTOM Tn.f%u LVWC CCCNITr CC. Tkll' on=.i //29/03 MUNICIPALITY OF ANCHORAGE 57— 1 N S P E C T/ 0 as Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street _ P.O. Box 196650, Anchorage, AK 99519-6650 n /tJ N F C / / �.� (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jan 28, 2003 Expiration Date: Jan 28, 2004 Permit Number: SW030012 Parcel ID: 015-151-38 ELegaibesciiption.' SOUTH LAKEWOOD HILLS #1 BLK 4 LT- 6' Design Engineer: 0041 AK Water & Wastewater Consultan, Site Address: 006251 112TH AVE E Owner Name: Jackie Repp Lot Size: 30389 SQ. FT. Owner Address: 6251 E 112TH AVENUE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516-1825 This permit is for the construction of: Q✓ Disposal Field 7 Septic Tank ❑ Holding Tank E] Privy E] Private Well E] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by catling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 112003 Date: 2 8 103 Municipality of Anchorage Development Services Department Building Safety Division 5111T♦ On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-151-38 Permit Number Sw0100/Z Property owner(s) JACKIE REPP Day phone 742-3603 Mailing address (1) 6251 EAST 112 AVENUE Mailing address (2) ANCHORAGE ALASKA Zip Code 99516 Legal description (Lot, Block & Sub'd.) SOUTH LAKEWOOD HILLS #1: LOT 6. BLOCK 4 Legal description (Section, Township & Range) N/A Lot Size xAcr Sq.F Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS. INC. Permit Fees: 400 - Date of Payment: w�o (;;L Receipt Number: ZVI l Waiver Fees.. Date of Payment:so f): Receipt Number: 210 /p Ll ALASKA. WATER & WASTEWATER CONSULTANTS, INC. �- October 28, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Ref: Proposed Well and Septic System for Lot 6, Block 4; South Lakewood Hills #1 ADVANTEXT" TREATMENT SYSTEM To whom it may concern: 1. GENERAL: The existing 4 bedroom home is served by a private well and septic system. The existing drainfield is completely surcharged and needs to be upgraded. Two test holes were excavated on the property. We are proposing to design the septic system around the 30 foot radii of these test holes. Due to the limited receiving soils and high groundwater, we are proposing to use an Advantex treatment system and a 5 -wide trench type drainfield. 2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring, and the percolation test results. 3. DRAINFIELD APPLICATION RATE: A percolation test was performed in each test hole and the rates ranged from 24 to 48 minute/inch. The Advantex system has received class III approval and we are going to conservatively assume an application rate of 3.0 GPD/FTZ. 4. TRENCH DESIGN: a. Percolation Rate: 24 & 48 minutes/inch b. Proposed Application Rate: 3.0 gallons/day/A2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 200 f12 f. Total Depth: 4 feet (max.) g. M.O.A. Approved Sand Filter Depth: 2+ feet h. Effective Depth: 0.5 feet i. Width: 5 feet j. Minimum Length: 42 feet long 6901 Debars Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 -- Fax: (907)338-3246 k. Effective absorption area: 210 R2 5.ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 6. SURFACE WATER: There is no surface water within 100 feet of the proposed septic system upgrade. 7. TOPOGRAPHY: There are no slope concerns in the area of the proposed drainfield. 8. CLOSING: I am open to any suggestions from your department that would be an improvement to the proposed system. I am unaware of any negative impacts that this installation would impose on adjacent wells, or septic systems. If you have any questions, please call us at M.S. NOTE: Attached is a site plan drawing, a design drawing, an Advantex detail, a trench detail, two soil logs, and a 7 page constniction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246 I I I I SOUTH LAKEWOOD HILLS S/D fl; I ( I ISOUTH LAKEWOOD S/D /1; HI SOUTH LAKEWOOD HILLS S/D /1;1 LOT 1, BLOCK 5, 1 I 1LLl LOT 1, BLOCK 4, I I 2. BLOCK A 1 � I � \\♦ I I � I I I 1 I -------------- L_-_--_ l-_--__- -< \♦ r-----7--------- \ -----_-_--_ __� L -------------- "1l -------------- - � r I SII Y 00• JI j Q '1 O I W I I I O' Z I \ I \ I I 1 1 I I ,I�±- \ jII�A p� EREAD I Q I Ld SOUTH LAKEWOOD HILLS S/D /1; j SOUTH LAKEWOOD HILLS S/D f 1: i SOUTH LAKEWOOD HILLS S/D /1;1 I QI \\ LAT 3, BLOCK 4.,/ I I LAT 4, BLOCK 4, LOT 3, BLOCK 5, L I I ' cy—V PROPOSED SEPTIC SYSTEM E DESIGN PACE 2 0 4� / \ Z j EXISTING SEPTIC JW 7 I SYSTEM t NEE I \ i ' \ 11 >: / I I ♦ 1 I 1 I I \SOUTH LAKEWOOD HILLS S/D /tj I j SOUTH LAKEWOOD HILLS S/D j1;j j I % ! I \ LOT S. BLOCK 5, I I I LOT 5, BLOCK 4, \ ' 1 j�SEPTIC I I p\\�� C EiREAC ti i '* ♦\ I I I �/ �� I I I I I .` ___jE. L----------------------4---------1------------- \\ Bml oo OUSE' 112TH AVENUE-' i I ARS 1 I f ' I o� i N ti 1 / \`\\ \ ♦`\\\s�W w l I Qg I /� JI LLJ DATE 10/28/2002 e._•l_ell�� -3._-- — -. _-t `f� DRAWN L1Y ALASKA WATER & WASTEWATER Z.T.G. �' M CONSULTANTS, INC. � 4 . ..../j %* . ... . ...... ............ ��� 6001 DERARR ROAD, SUITE 2R •ANCHORAGE. A% 09504 •PHONE (907)337.6179 • FAX (907�339.32L6 1 � 100, i PREPARED FOR PHONE NUMBER: PAGE NUMBER: JACKIE REPP (907) 742-3603 1 OF 4 �'of Gorness, i% �{�',��. '•. E-7953 e`�: LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS 1; LOT 6, BLOCK 4 "\d/'rofeselo.n�c�' TYPE OF WORK: SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE y PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 4 FEET DEEP MAXIMUM BY 5 FEET WIDE BY 42 \ FEET LANG. ADD 2 FEET OF M.OA APPROVED LEVELING SAND AND THEN ADD 0.5 FEET OF CLEAN, WASHED SEWER DRNNROCK. THE UNE I SHALL BE 1.25 INCH SCH 40 PVC WITH 1/4 INCH \ / HOLES FACING DOWN EVERY 24 INCHES,\ p e _ — — — — — — — — — — — — — — — — — i — 5' UTILITY EASEMENT I \ r0 01 / \ ITH/2 6 /— I � 0 � M44j�b.6i / I \ e C I \ e Ra�Di50ALLtL��T TREATMENTSYSTEM WITHISON (SEE DESIGN PACE 3 OF 4) ..•+r. / INSTALL FOUNDATION LJF— J EXISTING DAND ILD IS a f' SURCHARGED AND S TO BE �•. CLEANOUT LdI x CI MPLETLY ABANDONED •.;, -. 1 0 / Q EXISTING SEPTIC TANKS TO gm �ppA1G Hp E \ Z BE ABANDONED PER UPC / \ z ME .,1.:. I �y/APPROXIMATE WELL s : • ` • : :: �..: .. r I I RADIUS LOCATION : • Y , NOTE: THE CONTRACTOR SHALL HAVE THE NORTHERN LOT UNE AND ALL OF THE 100' PROTECTIVE WELL re RADII SHOWN FLAGGED BY A PROFESSIONAL LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. E. 112TH AVENUE DATE: 10/28/2002 r DRAWN BY.• �.• • • • '' S4O ALASKA NVATER & WASTE NVATER Z.T.G. CONSULTANTS, INC. SCALE: 30• ; 6001 IIFRARR ROAD. RIIITF PR • ANtWnRALF AK 0046E • CMONF mnm%7J 170 • FEY r007l%%R_\)LA PREPARED FOR: PHONE NUMBER: PAGE NUMBER: (/\� JACKIE REPP (907) 223-7694 2 OF 4 " ' e r Garn ss. LEGAL DESCRIPTION: DO —7 o G SOUTH LAKEWOOD HILLS S/D #1; LOT 6, BLOCK 4 TYPE OF WORK: 440�d�Dra(essio%�o����v DESIGN FOR SEPTIC SYSTEM UPGRADE ��40000 NOTE JIM CROSS, P.E. HAS THE ADVAFfTEX MANUAL a cRilm NOTE THE BOARD INSULATION TO BE INSTALLED OVER THE SEPTIC TANK & 4' BEYOND ON ALL SIDES EXCEPT UNDER THE ADVANTEX FILTER. THIS WILL ALLOW FOR HEAT TO ESCAPE FROM TANK & RISE TO THE FILTER ABOVE IT. 6' JIM CAP - FINAL CRADE---� (TYP.2) 6' PVC PUMP -OUT (TYP.2) 6' PVC COUPLING CLUED TO TANK (TYP.2) INLET _ OPTIONAL SLIDE SECTION OF 6' PIPE OVER THIS CONNECTION TO PROVIDE SHEER PROTECTION - EXTEND TO BRIDGE EXCAVATION AdvanTex" Treatment System ;a AX20 -Mode 1 a 40x94Pod �" UFT w AX20 POD DI AME RiRA7E TO PROPOSED DRAINFIELD 1 1,., ALASKA. NVATLR & WASTE NVATI CONSULTANTS, INC. 6901 DEBARR ROAD. SUITE 28 • ANCHORAGE. AX 99504 • PHONE (901)337-6179 • FAX (907)538-324. PREPARED FOR: PHONE NUMBER: JACKIE REPP (907) 223-7694 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS S/D #1; LOT 6. BLOCK 4 TYPE OF WORK: DETAIL DRAWING OF ADVANTEX TREATMENT SYSTEM 10/28/2002 po_ 4WN BY: Z.T.G. kLE: N.T.S. ....:...... 'E NUMBER: 3 OF 4 a . llfrp VAULT EFFLUENT PUMP A.. G....eS. .. -7953 \4�4 42 FEET LONG MTMT -------- ------------- 5 FEET I I WIDE L---------- ------ --------------------------J FROM PUMP VAULT 4 FEET DEEP MAXIMUM THE LINE SHALL BE 1.25 INCH SCH 40 PVC WITH 1/4 INCH HOLES FACING DOWN EVERY 24 INCHES. INSULATION OF APPROVED -,-SAND FILTER ----5' WIDE--, FABRIC 0.5 FEET OF EFFECTIVE " r}'I Val, 10/28/2002 Qac p q�"op 4 DRAWN BY: ALASKA WATER & WASTEWATER z.T.G V o, y� CONSULTANTS, INC. 001 DEOARR ROAD. SUITE 20 • ANCHORAGE. AX 90504 • PHONE (907)337.6179 • FAX (907)338-32L6 SCALE: N.T.S. p,,,,; ,,, V EPARED FOR: PHONE NUMBER: PAGE NUMBER: JACKIE REPP (907) 223-76944 OF 4 f y A. Garness: y '•, 953 ,.� \-o 0 ;AI. DESCRIPTION:Q SOUTH LAKEWOOD HILLS S/D #1; LOT 6, BLOCK 4 IE OF WORK: DETAIL DRAWING OF TRENCH pp 7(eeelogoa�'� 000a� e.% .ALASKA WATER & WASTE'VVATER I ---- CONSULTANTS, INC. 8901 DEBARK ROAD, SUM 28 • ANCHORAO AK. 99504 • PHONE: (907)337-6179 • FAX: (%07)3w-32" • akrrt.Can SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS S/D #I; LOT 6, BLOCK 4 PERFORMED FOR: JACKIE REPP DATE: 4/15/2002 DEPTH _�__ ORGANICS (feet) ::::==: TEST HOLM1 1-0/7/ FILL 7 8 9 10 11 12 13 14 15 16 17 18 SM/ML w/ SOME GRAVEL DEPTH TO GROUNDWATER DATE DRY ORGANICS SOIL CLASSIFICATIONS 6.0 2 6' — 0 }H#1 —�_ up �I { 1 i 2:24 — {, — 4 GW 4 3/4- ORG J, 2:54 — 6' — LOAM/SM 3:24 30 GP { ML V i zi GM CL 4 I GC OL °•� °o o SW MH 5-1- E. 112TH AVENUE SITE PLAN SP CH MSM ��.'OH 6 #Sc 7 8 9 10 11 12 13 14 15 16 17 18 SM/ML w/ SOME GRAVEL DEPTH TO GROUNDWATER DATE DRY 4/15 2002 6.0 ------------------ � - ;TH#2 6' — 0 }H#1 —�_ 110" it"Jim Je re A. Gamess: 7953 v DATE READING 19 CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) -------, { ------------------ � - ;TH#2 6' — 0 }H#1 —�_ up �I { 1 i 2:24 — {, — 4 2:54 30 1 4 3/4- 1 1/4- 4'5 5 2:54 — 6' — { 3:24 30 a { { i V i zi 8� < I � T E. 112TH AVENUE SITE PLAN DATE READING 19 CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 4/16/2002 1 1:54 — 6' — 2 2:24 30 4 1/2- 1 1/2- 2'3 3 2:24 — 6' — 4 2:54 30 1 4 3/4- 1 1/4- 4'5 5 2:54 — 6' — 6 3:24 30 4 3/4- 4' 1 1/4- 19 PERCOLATION RATE 24 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) j I TEST RUN BETWEEN 6.5 FT. AND 7.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: JASON WOOD COMMENTS: PERFORMED BY A.W.W.C., INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Opo ALASKA. WATER & WASTEWATER --� "�-"��•�-- CONSULTANTS, INC. .... 4 . y*� 6901 DEBARK ROAD. SURE 28 • AK. 99504 • PHONE: (907).137-6179 • FAX. (907)&M-3246 • • aknY,o SOIL LOG - PERCOLATION TEST 0 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS #1: LOT S. BLOCK 4 eff y ss PERFORMED FOR: JACKIE REPP DATE: 10/22/2002 �0�� C 7953 \��p DEPTH 4��e��'ro/essio�°& 25 (feet)? ORGANICS ITEST HOLE #21�O�00000a 1 SOIL CLASSIFICATIONS 2 ML GM CL 4 I GC OL -------, ---o ----------- r TH#1 -7 0 SW MH D �I 5 . . SP CH SM OH QI 6 GM SC Z' 7— DEPTH TO i I j �I T 8 i ---��------ 9E. 112TH AVENUE �� SITE PLAN 1'100' 10 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP 12,11B.O.H. 13 14 15 16 17 18 19 PERCOLATION RATE 48 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.0 FT. AND 6.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: MATT FISHER COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DATE GROUNDWATER DRY 0/22/200 9,9' 0/25/2 0 cit -el TIME (MINUTES) READING (INCHES) Io 0 2:27 - TIME (MINUTES) READING (INCHES) 10/25/2002 1 2:27 - 6" - 2 2:57 30 5 3 8" 5 8" 3 2:57 - 6" - 4 3:27 30 5 3 8" 5 8" 5 3:27 - 6" - 6 3:57 30 5 3 8' 5 8" SOUTH lA OOD HI S D / UT LAKEWOOD HI I S/D UTH LAKEWOOD S/ LOT 1, 5, T 1, BLOC LOT 2, BL 4, O L 00• E( O RA07VS 70 ' ty Z C � Q w U' OUT 00 ILLS S 1; SOUTH LAKEWOOD HILLS S/D /1; H LAK D HILL S/ j ; T , BLOCK 4, LOT 4, BLOCK 4, .1 L 3 BLOCK 5, AREA I O 2 0 S LAK OD HILLS S/D j1; SO H ODD HILLS S/D 0T S, LOT 5, BLOCK 5, g [SEPTIC FIELD VERIFY AR S - - 12TH VENUE BEDRTOM HOUR ri -, i Jy ARPTI Q 1 N < in JO �~ N p J 1V5 i I WELD DATE: `J 4/1 2 2 DRAWIf BY: K..w. ALASKA NVATL'R & WASTEWATERS 1\=\i 00, -,^ •••.^y. m...^^^^ -•a-^ CONS`ULTANTS. INC.-r..,-a--^^M=-�^--. 401 DEB4 R R A0, ITE • AN[MDRAC p. AK 995 4 PHONE (90 7537.6179 • 907)338J2 P EPARED OR PHON NUMBER: C U ER JACK PP (907))742 3603 1 0 LEM DES RIPTIO SOUT LA EW OD HIL S LOT 6, BOCK 4 TYPE OF RK: \TOP GRAPH CA DR W SIG Sent By: Alaska Water and Wastewater Con; 907 338 3246; Jan -2-03 3:56PM; Page 2/2 Municipality of Anchorage Development Services Department +.r Building Safety Division On -Site water and wastewater Program GA try 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343.7904 PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated- ` y adonis made between the Municipality of Anchorage Development Service a artm (DSD) and the prope owner s) of: Pj �'� .�.�9s�y t>' deol This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owner> agree to the following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. Va<41zPz_[ij7 S- o A —� (Print6d Name) (Signature) (Printed Name) The Foregoing Instrumen was acknowledged bcj'gIe me by on this G'"'� day of 20 0 ll, my hand and s (N6tary's printed name) My Commission Expires My Commission Expires 5 05/28/2003 16:15 3453287 MY MILLING, INC ,1 PAGE 81 M -W MILLING, Inc. P.O. Sox 10378 0 10* W&WaM Highway Ath,Jat'(Lu 1. (907) 3494R636 ANCHORAGE, ALASKA Mll 42. DJULUNG LOG P".0, -tD410j Welt Owner SiTEPHAN33RE"CQUE(YIf REPP Use of WeU)0XZS=JC_' Location (address of: Township, Range, Section, if known; or distance iuMn r—d__ Td)T A P Br.nox 4 P qnflT ITT, .q- NJ 6251 r 11 9TH AVE Sim of Aftj"g Gfl re"*$' Of JUP 180 feet Cased tm_L72A_a:Jeet Static water leveL445___3t. ".:j'Wow) land surface. Finish of well (check one) open end X Screen Perforited T'. 4 Describe screen or pedoftti ':"tL f & f tl Well pumping test a ils&ftr (minute) for --I.— hours wits of drawdown from static $&L Date of Depth in feet from ground surface 0 �To__!_ 2 _To �4 4 TO 36 36 rp 38 3 8 - -T()--22- --3-7—TO A 6 80 _TO +3A_ 1 -3 4 TO_' .t 5 9 159 161 161 TO 173 173 TO 180 TO �TO� �TOTO� WELL too . dt .: I . orinStions penetrated, size of material, color and hardness R M e-T.av* Mr.V. ATTMY. GRA FTILY 3 —CONTRACTOR // .. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 82.5 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM ARID/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW �»J� �/ EDS' ' /� —Atop _ _.._ i �-�1U IZ-FJPGRADE MAILING AD <Sierq Rte- ve ii''V-� 7 LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS E. DISTANCE TO: Well f - + Absorption ap Dwelling -�r� PERMIT 0. �Q (of 67 y E. Q Manufacturer Material No. of compartments IFw Liq. capacity in gallons Inside length Width Liquid depth C>IF HOMEMADE: DISTANCE TO: Well Dwelling PERMIT NO. z"C Liquid in 2 Manufacturer Material capacity gallons Well Foundation Nearest Jot line PERMIT NO. JM W DISTANCE TO: a zNo. of lines Length of each line Total length of lines Trench width Distance between lines 2 w inches Top of file to finish grade aterial beneath file Total effective absorption area O inches Length Width Depth PERMIT NO. W 7 Q H Type of crib Crib diameter Crib depth Total effective absorption area — w Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J Lu _ _ Building foundation Sewer line Septic tank Lu Absorption area (sl DISTANCE TO: OTHER PIPE MATERIALS N SOIL TEST RATING airy 2' 7 - I T _ INSTALLER --t E REMARKS 44A-ezL& *�' .3d r sr' L!• - 19 70 �( ✓tS bG< < C�I?_c LEGAL APPROVEDD�J,J,//� /Dy/AjTE yx 72-013 (Rev. 3/78) /) 1 �EPH[�TMENT L HEHLTH ��D ���YIRO�MEN�HL JTECT�(}N ^ 825 'L' STREET, ANCHORAGE HK995w1 261-472� m wn to cv, 2 aEv ' PERMtT �O ( 820�16 ) HPPLICHNT STEPHE� H REPP 5RH BOX 4E 99507 ]49-7�88 � LEGHL L6B4 SOUTH L��KEWOOD 1 -ILLS LOT STZE ?�99�9 S9UHF�E� FEET TYPE OF SOIL ABSORPTION SYSTEM IS. TRENCH NAHXIMUM NUMBER ;,DF BE[`ROOMS �4 SOIL RHTIN(A (SQ FT/RR)- 214 THE 4001AIRED SIZE OF THE SD1L ABSORPTION SYSTEM TS� �NET ���- , Alto ������� PET CA FQ FA NYER 10 K 101 f- 1-1 - 12.41 THE LFMGTX E.INEMSIO�� IS THE LENGTH CAN FEET) OF THE TRENCH OR DRHINFIEL0 THE DEPTH OF OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE SR�i�ND H�D THE BGTTOM OF THE EXCAVATION (IN FEET), THERE IS ;O GET WIDTH FOR TRENCHES. T�� GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFALL PIPE HND THE BOiTCM OF THF: EXCFAYHTION (IN FEET). ESZE�K> 15Evu�-4 f Q 7-1110107 E.: -F �� �<�,'! F:::E! ... . . . ...���� PERMIT FPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTHLLHTIOM INSPECTIONS OF ANY' WELLS HDJHcFNT TO THIS PROPERTY AND THE NUMBER UF RESIDENCES TwT THE WELL WILL SFRVE, _~~ �,�� ��� E ����������� ��� �������� 8SCKFILLINS OF HNY SYSTEN WITHOUT FIMRL INSPECTION HMD APPROVAL eY THIS 0EPHRTMENT WILL BE SUBJECT TD PR0SECUTION !'}INIMUM DISTHHCE BETWEEN H WELL. AND ANY ON-SITE SETIHGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIYHTE NELL OF! 150 TO 209 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC |�ELL MINIMUM DISTHNCE FROM H PRIYHTE NEL. TO H PRIVATE SEWER LINE IS 25 FEET AND TO H C3SMUNlTY SEWER LINE IS 75 FEET, OTHER REQUIREMENTS MRY PAPPLY, SPECIFICHTlnNS AND CONSTRUCTION DIHGRHMS HFE HV9IE E TO INAURE PROPER INSTHLLRTION. �NE To 11 T 1" EE T-7 & 1: FQ VE AL ��m: !*;� 1 Q to! 20 13 0" 1 CERTIFY T49T J. 7 S|1 F�MILIHR KATY THE RERUIREMENTS FOR ON-SITE SEWERS AND HELLS HS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE 2. I WILL INSTHLL THE SYSTEM IN HCC=DHNCE HITH THE CODES ]: I UHDERSTHND THHT THE DN -SITE SEWER SYSTEM MHY REQUIRE ENL&RGEMENT IF THE RESIEEHCE TO REMDDELED TO INCLUDE MORE THHA! 4 BEDROGMS. � � /J �� ^�� �� STANLEY BRUST chi ASSOCIATES Engineers - Planners - Survevors 1317 East 74th Avenue Anchorac, Alaska 99507 (907) 349-6577 L- PTIC SYS iLM ADEQUACY REPORT l JOB NO. DATE OF RF_PDRT DATE OF TEST ..--�a-/��vu 1; !�,• /�/S LEGAL DESCRIPTION LOT _.___—, BLOCK—.--,-�-_ - UE DIV: SION' PERFORMED FOR: OR- SECI IDN _____—, T- -- N , R ----'W , S. M. , ALASKA REQUESTED BY: TYPE OF SYSTEM : 0SEPTIC TANK - SIZE __,�-�--- GALLONS gef CR16 OR SEEPAGE PIT a LEACH FIELD l,, FI eY� NUMBER OF BEDROOMS F. SEPTIC TANK WAS PUMPED O YES peer NOTES 8 OBSERVATIONS: 4-11 -° L' /_/fir /G • ✓cam Cel• Sir ?s s TEST PERFORMED BY:-eV,1S/ REPORT APPROVED BY. _ _ .__-- STANLEY BRUST R ASSOCIATES' Engineers - Planners - Surveyors Adequacy Test Log Legal Description No of Bedrooms Project No. 6� 0 Q1 Date Time Level Readings Remarks septic tank zz fly, 711z - 5s i s �1 41 GRE. ". ANCHORAGE AREA BOf 3H Department of Environment Quality V9 3500 Tudor Road Anchorage, Alaska 99507 Zlr'C-7/0/lof --77'' ''I//NSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME %7'J7d-n/ P�l<Fr.!)91"0A-1 MAILING ADDRESS PHONE 07- b Z- 0 CK c,/ '5o. ,Cfi/<C-zr�ooa� LOCATION no L/L (Zi/�C'E �o' LEGAL DESCRIPTION / C TANK: DISTANCE FROM El INSIDE LENGTH TILE DRAIN FIELD: FACTURER INSIDE WIDTH _ LIQUID DEPTH NUMBER OF LIQUID CAPACITY GALLONS. TOTAL LENGTH DISTANCE FROM WELL �� /f -FOUNDATION Z" / NEAREST LOT LINE OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES — TRENCH WIDTH�'y IN, TOTAL EFFECTIVE ABSORPTION AREA a3t-% �/ SQ. FT. LENGTH OF EACH LINE - / DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE 'S MATERIAL BENEATH TILE WELL: TYPE"/"'- CONSTRUCTION 36 IN. ABOVE TILE �?- IN. DEPTH 7X / DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC /f SEEPAGE FOUNDATION O LOT LINE -2--d! SEWER LINE , TANK `SYSTEM— CESSPOOL YSTEM CESSPOOL OTHER SOURCES APPROVED ✓ DISAPPROVED REMARKS DISTANCES: At INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: oleo-UGe}gEYtg LOT SLOPE: REMARKS: P"T Rig-77G/Z7- 0^/ %Hn(K t t EW -WO- 7 - Form PW -027 DIAGRAM OF SYSTEM 3 FJvR-„-I .:5 /A/C LE F~ / + L/ DATE 9L'z-0`77 APPROVED q l� >IyNs of 3.zT Low 9. G.A.A.B. C.0< 1 0 NAME OF APPLICANT GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. GIPC�r�I�F SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT SQA 2z./-1 / 3�1�-gF 3 MAILING ADDRESS PHONE INSTALLATION LOCATION leo C �L// R OC>E e51 LEGAL DESCRIPTION 4C 7 - INSTALLATION INSTALLATION OF: SEPTIC TANK / SEEPAGE PIT , DRAIN FIELD L� OTHER TYPE AND SIZE OF FACILITY TO BE SERVED ' "' ~(Q L FINANCED THROUGH �T TO BE INSTALLED BY Jp�Al �O SOIL TEST RESULTS 2/ (I ` NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED ' ` -/ytffEVS ¢ai /�vo. L S�/1/fj7onl FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK . SEEPAGE PIT TO NEAREST LOT LINE. DRAIN FI DR WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD /o fi ALSO CONST[ WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, . SEEPAGE PIT TO RIVER, LAKE, STREAM, SEEPAGE DR, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO C EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC 7 FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTAL G.A.A.B. OR LICENSED DESIGNER SEEPAGE AREA SIZE bwawo DIAGRAM OF SYSTEM I CERTIFY THAT AM FAMILIAR WITH THE REQUIREMENTS OF GREATER DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE 7- -2 'P _ / 'V_ APPLICANT'S AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE G"QTER ANCHORAGE AREA BORO'"%H HEALTH DEPARTMENT NO ` 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM f MAILING �f/-'7 -5t NAME �(-e'�1� // /N-1 ADDRESS S, LSI i nrnnnKi /H. (?1 -"lam b° IGi U c j!%f v e,- LEGAL DESCRIPTION 40f 6J/k SEPTIC TANK: d M �cl ln a d -C Tii n, 302 PHONE DISTANCE FROM WE LO' ��f�E`��'�"'MATERIAL C�©YC'✓c.'f,/C�r® COMBER OF MPARTMENTS f T LIQU LIQUID CAPACITY lIi of GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTHID 7 SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS ` OUTSIDE DIAMETER OR WIDTH ? �( LENGTH !r DEPTH LINING MATERIAL f S . DISTANCE FROM WLYL E ��t abll i✓'i'cl ,)UILDING FOUNDATION ��f NEAREST LOT LINE 2`C} � ._ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) b' r7 SQ. FT. TILE DRAIN FIELD: DISTANCE FROM NUMBER OF ISTANCE BETWE DEPTH: TOP OF TILE TO FINISH GRADE_ WELL: TYPE / f''L'Si'cl Gy FT. LENGTH OF EACH LIN NEAREST LOT TOTAL LENGTH OF LINES TRENCH WIDTH `_T- IN. TOTAL EFFECTIVE OF FILTER MATERIAL BENEATH ABOVE TILE DISTANCE FROM - --WATER Ri-m-nimr-FnriwnAfi nN SAMPLE _ . NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE---5€WER-61Nf - ""� _ ,TANK ,-SYSTEkT -- - --, CESSPOOL , SOURCES_ DIAGRAM OF SYSTEM DISTANCES: DATE 4Zdl C� / I / `7 GAAE-HD-2 GREATER' �,NCHORAGE AREA (._`)ROUGH Case No. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT fo, k i; NAME OF APPLICANT h��� K' -L- 1 ?(k)k)A.1.S0kAILING ADDRESS 12 PHONE NO. RESIDENCE ADDRESS C P1 23 11 C(k t,C`I LOCATION OF INSTALLATIONI\ CK Iii+ (IcC LEGAL DESCRIPTION L(A 6 CLIC APPLICATION TO INSTALL: SEPTIC TANK V"� , SEEPAGE PIT V`�_ , DRAIN FI TO SERVE THE FOLLOWING FACILITY OTHER FINANCED THROUGH ` 7 c� L F TO BE INSTALLED BY �C-I � 7 PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION l Y" UC)(LL,j- . BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS —h -La a ii RAUk)426CiAPERMIT TO INSTALL SEPTIC TANK SIZE 521) TYPE Ct" F)LC'(' DISTANCES: 47 6_' oc), (-I �' i k 4-1) - / / OR ��UICENSED DESIGNER r�EEPAGE AREA TYPE DIAGRAM OF SYSTEM 4 I certify that I am familiar with the requuemenfs of"Greater Ancharag6-A Pea-$o�5u rPII-Id� rrznre28=fr what th above described system is in accordance with said code. 1 c t APPLICANTS SIGNATURE DATE [767 E■■NONliMEME■■■■■■N■■■■ NEON 1■■ EMMI■■■■■■■■■■■ 4 I certify that I am familiar with the requuemenfs of"Greater Ancharag6-A Pea-$o�5u rPII-Id� rrznre28=fr what th above described system is in accordance with said code. 1 c t APPLICANTS SIGNATURE DATE [767 ""'EATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT CASE /1 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For Robert Hawkinson Date Performed 2/24470 Legal Description: Lot6.Block L1 Su iv�sion Southwood Hills This Form Reports a: Soils Log --ix— Percolation Test M I; Depth Feer Soil Characteristics 1 M � i 1 i f 1 Was Ground Plater i;Tcountered? If Fes Atat ;;e;th Location Sketch Rea-, _ n Time Net Time Depth brown clayey silt (CH) •' m.. } Drop gray sandy gravel (GW) gray gravelly sand, silty G: i i gray silty sand (SM) 1 M � i 1 i f 1 Was Ground Plater i;Tcountered? If Fes Atat ;;e;th Location Sketch Rea-, _ n Time Net Time Depth Net •' m.. To H` 2-n -- Drop —._ime r.X -171717 �e Prr,c�sed ;n t t'a Seepage Pit xx Drain field DePLh �f Inlet Depth To Bottom Of Pit Cr 'Trench COMMENTS - 214 square feet of drainage area is require per be room N Test Performed By: R. E. Carlisle These recommendations are computed from visual observation and based on the uni- fied classification system. Data Certified By: National Testing Service Inc. Date: COtr3, i.ielp,-ollltyP of Ant, c dna ,e 825 "L" Street RickMystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor htip://www.ci.anchoragc.ak.us 343-4744 August 1.8, 1998 Stephen A & Jacquelyn S Repp 6251 East 112th Avenue Anchorage, Alaska 99516 1825 Subject: Lot- 6 Block 4 South Lakewood Hills X11 Permit #SW970259, PID #015-151-38 The subject permit, issued August 1.5, 1997 by this office for a single family well and/or on-site wastewater system, has expired as of August 15, 1998. A new permit must be obtainer from this office for a well and/or on-site wastewater system NOT installed by the expiration date. if you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit, Ii a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for r -view, approval and documentation. All inspection reports rust be submitted within 30 days of construction completion. 1,,11'en applying for a new permit, the fees are: $320.00 for an on --site wastewater permit; $120.00 for a well permit and SZ,40,00 for a combined on-site wastewater and well permit. If you have any questions, S-incerely, i t rP ( F 1 James Cross, P.E. Program Manager On-site Services enc: Copy of Permit please call this office at 343-4744. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970259 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:REPP STEPHEN A & JACQUELYN S OWNER ADDRESS:6251 E 112TH AVE ANCHORAGE, ALASKA 99516 PARCEL ID:01515138 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS #1 BLK 4 LT 6 LOT SIZE: 30400 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 8/15/97 EXPIRATION DATE: 8/15/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ABANDONED WELL MUST BE DE-COMMISIONED PER ANCHORAGE MUNICIPAL CODE CHAPTER 15.55 SEC 6J. (COPY ATTACHED) RECEIVED BY: �/'z��_-es�G�eyrGi✓(.C�iC7 sem% DATE:- -�-moi ISSUED BY: -.,,� �,, lL�a�� DATE: -- —T-- . 7777i_7774.� ' _ -- - -- .. 6477 .., 3 4 _i i (Rd :Joe•404 } J. yyy , i .+U I ♦F 1� s- 7-1 � I �' �4 _ �Z SrY _ Gon9e ♦ o WWW,,,OOtl00PPP T 1 ! ' I'� I 'OI 543 /i Srx ase. -r7-7O O q Gti PES well U i -1 _ - J. II a t, �yrN ��y TI u erdj4! i 40 �t TM,ENTS Of R CORD, OTHER THAN � �+�\+4 1 hereby certify that I have 'surveyed the following 'SE SHOWN N THE RECORDED m"� � Or H described property: Lal � =� � ; So, •fib T ARE,NOT St WN HEREON A•••"'•"••.'Q ^ 3 - - .pC2�4 . ."�9 0 Z al -.p W .J ILIA �- l � Add, %4::; ... Anchorage Recording thereon Alaska, and that rty 7 improvements situated thereon -are within the ro ert / lines and do not overlap or encroach on the property Fred Wo6fia �om / lying adjacent thereto, that nol improvements on prop - sl •.• NO. 345:5 0 erty lying adjacent thereto encroach on the premises m Q q •,• oQ i question and that there are no roadways, transmission _ - - - -- -- - - e$�� R�FfSSI0R1,L�h�,� r �- - • lines or other visible easements on said Property except as indicated hereon. Dated at Anchorage, Alaska this / L day pAacy•19 4 FRED WAIATXA & ASSOCIATES Engineers and I Surveyors .P9-76 � fJ 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 %Z —/G-4'7 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) 1-0-k & L joT/'r 4 Y vf/ L. z.>-.iri-•f /�'G* S' d i Location (address or directions) (b) Property Owner /Ce -mow Telephone: Home ''3�lf Business Mailing Address iv2S� //yam (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: or: Check here 11, if hold for pick up. List contact person and day phone number below. !n7tI t'% 117 ` 2. TYPE OF RESIDENCE Single-Familyy)t Number of Bedrooms - 3. WATER SUPPLY Individual WeCommunity ❑ Public ❑ Note: If commu//ni``ty well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public El Community El 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 8/66) Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm '15Yl Telephone Address Date --;- Engineer's Seal IN i i IT ,v.J f:o. 2855-: .✓ 6. DHHS APPROVAL �r Approved for l<, k)_ bedrooms by Approved Disapproved Conditional Date Terms of Conditional /Approval �✓ //02�T1 al+� ire / M �� 0 13:fr1 � s?�az r7v lel -4r/— f Ger ! r/EeEa dh�15 CAUTION rrn I 7T" 44, /•d; /<'Fif% 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 theirlending 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 (P,o e+ee) Back A. WELL DATA pF H�G�NOPALITY OF ANCHORAGE (MOA) ALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Legal Description: /,til '/� &/"c%'o/- wz-v9 /4115 5'=- 6</; Well Classification°"' �`j If A, B. C, D.E.C. Approved (Y/N) 1A Well Log Present (Y/N) `92 Date Completed IGM)x Yield Total Depth /7k" Cased to Depth of Grouting Static Water Level '4K- ' Pump Set At f Casing Height Above Ground -Y Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) X %2 Depression Around Wellhead (Y/N) f Separation Distances from Well: To Septic/Holding Tank on Lot (� On Adjoining Lots . To Nearest Edge of Absorption Field on Lot /C.- ; On Adjoining Lots To Nearest Public Sewer Line %2. % To Nearest Public Sewer a CleanouUManhole �h_4- To Nearest Sewer Service Line on Lot Water Sample Collected by Date / 7_/-�'- Water Sample Test Results Comments f'vaa - c✓zr/ B. SEPTIC/HOLDING TANK DATA "'S"e- � .�/ 74- /vz7J�a� Date Installed Size No. of Compartments Standpipes (Y/N) '?, Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) /20 Depression over Tank (Y/N) Date Last Pumped �/ zglls-' Pumping/Maintenance Contract on File (Y/N) `A A.1 ; for Holding Tank High -Water Alarm (Y/N) ten' A Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well 'SU'_�/- fi To Property Line / To Building Foundation To Disposal Field /OzIA- i AJ. /A. To Water Main/Service Line S To Stream, Pond, Lake, or Major Drainage Course Comments -7L L-� �=„ RCe -. y s`-..-.� �.-� %vim.✓ UZ��,.�--2_ /�,h� GiL�o✓'ari Page 1 of 2 72-026 (Pev. 8/861 Fr.0 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata L l Type of System Design r Date Installed / iTC' _ Z' Length of Field A� r Width of Field __ y� ' Depth of Field — �'r �/V t� Gravel Bed Thickness 3 r(%t�e=�c� �x,� 1771 Square Feet of Absorption Area _ 6-1Z,-` Depression over Field (Y/N) _AID Results of Last Adequacy Test—S'Fr77t "7'/ae7 Separation Distance from Absorption Field: ,___ r r I o Water -Supply Well _ To Building Foundation Lot /Jv= 4 To Water Main/Service Line /cam r >< Standpipes Present(Y/N) _ x —_ Date of Last Adequacy Test /Z--/J- To Property Line 1e,r- To Existing or Abandoned System on On Adjoining Lots — /G -e) r¢ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area �'Sr Comments _ f//w�` /lavuc•C� ,t,� o-,.:r//�2�aJJr�-„-ate//,=P'F-�Zc_ < �iG_., �J/.. i��._..-C-./ .e.e�-.t7 Z.---_/%�—Y-D 112- / � %Ca?i. /(l BC.t/t7 iL✓__<G�a tY � e'TC `�C/S�=s-t. 1P3� 6uei fe w. �o<L ce,&, or a� �e a a(LcGCoYy s 1� ✓21 a� r� D. LIFT STATION .� Date lnstalled _ _— Dimensions Size in Gallons _ Manhole/Access (Y/N) "Pump On" Level at ___—______— - -- __— _--__ "Pump Off' Level at High Water Alarm Level at - _ — —--___ _Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments _-----.-_--_--------__- «« Check Permitted Bedroom Rating Against HAA Request «« I certify that I have checked, verified, or conformed to all -MDA and HAA guidelines in effect on the date of this inspection. Signed —---- -- Date - --- Company MOA No. -- Receipt No Date of Payment l' ,l Amount: $ �ZU • QU r� Engineer's Seal;) f 1 Page 2 of 2 r ;+ f,. ., 7?-0261R,v 31861Rnck Client's Address: TESTER: (� �n BESSE, EPPS & POTTS 2220 EAST 88 AVENUE ANCHORAGE, AK 99507 (907) 349-6451 WATER ;qEr i, TEST Date: /. 'Vd--,? )- Subdivision: GPM Lot: 6 T R READING Block: f� 40- Initial Reading on Meter: 6dpf _ /SD Xt/ _ ln; 9�/ -/-10 DRAW DOWN TIME GPM GALLONS GALLONS FIELD VOLUME TOTIU iACNI2OR T R READING /o ; 40- /a, :z ! x o 5s-0 �/(z 9' -7 0:33 a '/ 6 9S. /,0, V3 S 70 � SS 06 3 a ( X SGoS / ;a6 s 3 6 c? S / 9 — _ 4 Y6 7 3 X39 69?/ o2l a:v6 3 V �a'•36 3.y 3�% 03 � 3a �s 69k/y �. E4k�3 _�( Srop NOTES: Production Rate: 144 GP:: 2= -:;our CapaciD! Ga 11_cr. dt // / L of f1 F. .fJ.pll�P.YI f�•t C1 �i147It'`ir=Hz�/ c 1 ,,I'AC<(/ 1� in !li E�.Ii� ✓t >ff r tr!! VI'.'�6G�M & 114> �Jcc rl . loss / 44keY /rPNl 4J7- Av - 3k /1X'2 "- 11A II�,1]j,C��-,�j((�� '➢({('�jj41���' ������ � / 600 Ujmvi F3 I rY r,[ -AZA WL"T UI7[ A FAIRBANKS AI ASIA 99709 9074793115 2',05 1 AIRBANKS S1 BEE r ANCHORAGE ALASKA 99503 9072718378 Besse, Epps, & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 Source: L6, B4, S -Lakewood Hills Sample ID#: A121587-10 Parameter Unit Nitrate -N mg/L Result <0.10 Date Arrived: 12/15/87 Time Arrived: 1430 Date Sampled: 12/15/87 Time Sampled: 1345 Date Completed: 12/16/87 h111,�[y5[K�3 I[0 Reported By: Date: 12/17/87 Carol J. Garrison, Vice -President k MCC = Maximum Contaminant Concentration Listed below are quality control assurance reference samples with a known concentration prior to analysis. the acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring -the accuracy of your results. Sample # Parameter Unit Result Acceptable Limit EPA WS 378-6 Nitrate -N mg/L 0.91 0.84 - 1.02 Reported By: Date: 12/17/87 Carol J. Garr. on, Vice -President Hi r )T I' IG F� "f"H)�i fr- 9 �� c � c , , 111 COO UNIV 9.`IIV PI �/AWE I 25Ob F AIPBANKK STRIH'f SW7CA FAIRBANKS BAMS AI ASIA 99709 9074793115 ANCHORAGE. ALASKA 99503 907-2778378 Quality Control Report Client: B.E.P. ID#: A121587-10 Listed below are quality control assurance reference samples with a known concentration prior to analysis. the acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring -the accuracy of your results. Sample # Parameter Unit Result Acceptable Limit EPA WS 378-6 Nitrate -N mg/L 0.91 0.84 - 1.02 Reported By: Date: 12/17/87 Carol J. Garr. on, Vice -President a INVOICE 20voc:1200 Z,Fl` S WER AND DRAIN �r° 7""&eQ CLEANING SERVICE Do" v the Z)Tai t- P.O. BOX 112688 PHONE 345-2513 ANCHORAGE. ALASKA 99511-2688 Reif —I ! Job Address Lo -t G E y SA MAN TERMS 30DA T CUSIOMEROROER. ROTO --ROOTER SERVICE CALL HRS @ STEAM THAWING HRS, TRIP CHARGE HRS. OVERTIME CHARGE HRS. ADDITIONAL LABOR CHARGE HRS. PUMPING SERVICE. S O ) (GAL) HRS @ HYDRO -JET SERVICE MATERIALS 'LEA EPAY FROM IS!NVOICE TOTAL ca) /O TOTAL FOOTAGECLEANED OR THAWED BLADES USED PROBABLE CAUSE OF. STOPPAGE!.. /1�Tn \il4a.L� LINE CLEANED all- Y—o El JOB NOT GUARAN CEED FOR FOL,OWING REASON WORK ACCEPTED BY 5. LEGAL DESCRIPTION ar- r J� Dt,.<ttECEIV ED INSPECTION APPOINTMENTS 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS T110E ❑ One ❑ Four ❑ Other TIME _ TIME ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well DATE depth (attach log if available.) DATE D T INDIVIDUAL/ON-SITE**'70 INSPECTOR ❑ PUBLICUTILITY 1 SPECT R INSP C O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION • 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not he processed. Please allow ten (101 days for processing. 1. PROPERTY OWNER PHONE J61,? wi-/9- MAI_ G ADDRESS CX 10- dol r1 YlC �1 DrQ. A PROPERTY RESIDENT Of different fro above) PHONE r) U 2. BUYER j +- e,r� F� - v J C iti C - PHONE MAILING ADDRESS Isotj feavu- P1 '41� )�,�� rK C5o� 3. LENDINGINSTITUTION�/PHONE IN 0 l 4 i :i 1116—l1J�d MAILING ADDRESS oi-1 hw) L-1 l ('t C " - , -3. t C .2 , t1 4. REALTOR/AGENT P NE MAIL 16)1 DR/ S (L/l v- c-,1�C�Ll-/-^�. Alin��I� 5. LEGAL DESCRIPTION ar- r J� STREETLOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM }} SYSTEM WAS INSTALLED. INDIVIDUAL/ON-SITE**'70 YEAR ON-SITE ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) p 72010 (R., 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ TWO ❑ FOUR ❑ FIVE ❑ OTHER ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED lO —r ?C3 •- l� �`_�y� INSTALLER ❑Septic Tank or El Holding Tank Size: 16P If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS V HPPROVEDFOR S BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE ,t- 9 ( BY 72010 (R., 6/79) ,�Cfoov,r 4 190 Ora in-, 10 0 Lot C ntewv ww:_A Mro . in "Va. ;.q�"Aj �kov Lb- 1PAQ1000 MAZE hij worve wwlj"I�q an�W� YQWMhim" "P -011 U—IL �rsl wiqv cook nab' v nav ON mail Wy opr ins, Ction a, vvtprLm I CMK`14flou L 3' awn to 1punre runWas Wwanno "I" -r &� W-1 1 Ono Aoaut zw� Low. ?k 3100Y COOL lAwn" V, �f: Ohfnrw�G an LAO r I oWW� te:t�atovAm it U. stip ji Slar"WrIane A ma Its may:. �-YVOW"j rao C040 in nwvjun�z. T"T? vopwm to al"JoLn'! ly. Clw -?yjCw ;nI not wavini, nvi"k E50 WIT to- �acz �Oft vw� 0 colon! naTion Oqo kV! nouoo -WmKwnwJvn A"vQ Koo& Movootod. 4 %nor, pop nn� AIMAMT .�wvlmn, _Ipsz- rn!! 0>10 Mflmc ot vn-wvw �"VOQLI 1", .1` or 0. :ratt A�Onw'ay. '�Vico , now"! V�AVWI ts" C it, o; rw ; 01 100al wo, 1 ainin", ALASKA OnUIROWnTAL COnTROL SCRUICOS, I11C. Engineerinq & Enuironrnentol Studies BECKY HANNON P.O. BOX 10-1306 ANCHORAGE AK 99511 STATEMENT SBDN SOUTH LAKENOOD HILL #1 SELLER— LAURA DELL SEPTIC TANK PUMPING ADEQUACY TEST 12/8/81 BLOCK 4 LOT 6 BUYER— 55.00 235.00 $290.00 IF DESIRED PAYMENT MAY BE DEFFERED '10 CLOSING AND MAY BE PAID FROM THE ESCROW ACCOUNT. PLEASE LET US KNOW. M� 1220 LUest 25th Ruenue m Anchorage, Alaska 99503 0 (90/ 276-1361 ALASKA OnUIROnn1CnTAL COnTROL SCRUICCS, Inc. Engineerinq & Environmental Studies MUNICIPALITY OF ANCHORAGE DEPT. OF I j, ALT, I & ENVIRONMLNVd 4:CTrCHQN 12/8/81 [+ !"?_;I RECEIVLD BECKY HANNON P.O. BOX 10-1306 ANCHORAGE AK 99511 SELLER — LAURA DELL BUYER— SUBDIVISION—SOUTH LAKEWOOD HILL #1 BLOCK -4 LOT -6 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 500 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 541 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 12/8/81 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. Ga"&. No. 3931E _a . 1220 West 25th Avenue a Anchorage, Alaska 99503 • (907) 276-1361 V/" GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" StreeWch age, Alaska 99503 274-4561 Date Received II�/ )'K. (l^Q Time of Inspection -/ Date of Inspection ! t�-4 '12M / 2 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested by: (.f-Gi122a� : T/t•rnc.� a I9 -D�30 Mailing Address: 9 3 Phone: Property Owner: V�z ✓ f�r� s-o,�/ Phone: 3 Llq— — 7 7 z —� lo� Mailing Address: 27Ll-V 1,K 3. Legal Description: 4. Location: /-� a-� v 5. Type of facility to be inspected SF 6. Well Data: A. Type Sd c -o . C. Construction No. of bedrooms B. Depth /7 J / D. Bacterial Analysis 7. Sewage Disposal System: Z-�; (-2 9/7 V /0///70 A. Installed B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: 2. Manufacturer 2. Material S/ 3 A. Well to: Septic tank Absorption area / do �f Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page -2 of two pages - Rek� .t for Approval of Indiviidual r & Water Facilities Legal Description 4d Comments std O-y-�V 17 " Approved t 'e"62is-6proved Date A rova ;Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) GREATER ANCHORAGE ARL,'BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONY 2. Property Owner: AIL Mailing Address: Day 3. Name of Buyer: Mailing Address: Day Phone 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: Location: Phone 7s Phone 7 7. Type of Facility to be inspected: No. BdrMs. 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well -z7la- 9. Sewage Disposal System Type of System: Public Utility individual (on-site) _k" If Individual, date of installation 1 9/ 1. Approva Mailing 2. Property GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection /tJ�O0 Date of Inspection d a 7 equest Mailing Address: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES ez b-v� a /� 3. Legal Description: Q°14�1���.<aihrn-'zi 4. Location: 5. Type of facility to be inspected No. of bedrooms 6. Well Data: 4, A. TypeB. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: N4 �-/ A. Installed/7d B. InstallerC. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 3 8. Distances: A. Well to: Septic tank d 1 , Absorption area / 1y , Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Request for Approval of Individual Se,..;r & Water Facilities Lggal Description d 0 -- Comments -Comments Approved -- R.2_ jJ �cnaDk�(pproved Date `3 Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this repuest for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. Date SIGNED EQ -034 (1/74) GREATER ANCHORAGE ARki't BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: 666e27 T Mailing Address: Day Phone fay- ��3y 3. Nary --f Buyer: J7'/0�Uel1V A Ati/&1,?&OV /rAI�/ ��geoc. A -L1 J WX'612 Mailing Address: 1_633 AJOe_ y�P eDay Phone X75-/302 4. Name of Lending Institution: _Z' LleST- A/Arro� &D 4 Mailing Address: PJ 6oy 1706 rN -kPhone_ 279-VVF1 5. Name of Realtor or Agent: S /iu�/��+/ /i��crV, SAT 1�,4'_IV' «_ Mailing Address 6. Legal Description: Location: s/ Phone 07A2 - 4 S-6 P T 6 6Z'D,- 'S_, CSN f -Y- mus —I r S e ,ua oc- 7. Type of Facility to be inspected: No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well /'%� 9. Sewage Disposal System Type,oi System: Public Utility If Individual, date of installation Individual (on-site) �/ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING !� // Parcel I.D. o15-45'1'7'2, R COSA# M c) [ r,U(d0? 1. GENERAL INFORMATION Expiration Date: 7 - a 9 - C1 q Complete legal description SOUTH LAKEWOOD HILLS #11# BLOCK 4, LOT 6 Community Class Well ❑ Public Water System Location (site address) 6251 E. 112TH AVENUE • ANCHORAGE, AK • 99516 Current Property owner(s) DENNIS WEBB Day phone 441-4794 Mailing address 6251 E. 112TH AVENUE • ANCHORAGE, AK • 99516 Lending agency Day phone Mailing address Real Estate Agent ALIKE MULNEAUx W/ REAL ESTATE BROKERS or ALASKA Day phone 297-2912 Mailing address 3300 C STREET #200 • ANCHORAGE, AK • •99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well N Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site N Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 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, SUrTE 101 . ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the tical soils condition, groundwater levels that may Ructuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for _�_ bedrooms. Disapproved. Date 417- zj0'q Je fr'f/A. GSar ess: pJ !. fCE-7913_.- Conditional .' FG s 1 • . Conditional approval for bedrooms, with the fllowing stipulations: Attachments: / COSA Checklisty Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other utllll01 r G\Qp y ON-SITE WATER AND ; r^= WASTEWATER PROGRAM 1 By: Original Certificate Date: —� 0 (R. 11,05) Municipality of Anchorage • '� Development Services Department _ Building Safety Division --- On -Site Water & Wastewater Program " 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SOUTH LAKEWOOD HILLS #1: BLOCK 6, LOT 4 Parcel ID: 0 /6-- fJr�-30 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N A Well Log (Y/N) YES Date completed 10/7/1997 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 180 ft. Cased to 179.85 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 12/15/1997 4/13/2009 Static water level 145 ft. 139 ft. Well production 12 ' g.p,m. 6.4 —g.P.M. WATER SAMPLE RESULTS: Coliform n colonies/100 ml. Nitrate 0. 10 mg./L. Other bacteria Q_colonies/100 ml. Arsenic:3.3-7ug./L. Date of sample: 4/13/2609 Collected by: GEG Ltd. B. SEPTICIHOLDING TANK DATA *ADVANTEX TREATMENT SYSTEM "'DOUBLE CLEANOl1TS PRIOR TO TANK Tank Type/Material 'FIBERGLASS/S.T.E.P. Date installed 1/29-30/2003 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YIN)"YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping — Pumper A+ "HOME SERVICES C. ABSORPTION FIELD DATA E ow EXISTING GRADE Date installed 1/29-30/2003 Soil rating Eiyor ft'/bdrm) 3_0 System type SHALLOW TRENCH Length 42 ft. Width 5 ft. Gravel below pipe 0.5 ft. Total depth *3.25 ft. Eff. absorption area 210 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/13/2009 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test E In. Water added 640 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — *NOTE: TRENCH WAS INSULATED WITH V BLUEBOARD INSLUATION. D. LIFT STATION •INSPECTED BY A+ HOME SERVICES. Date installed 1/29-30/200 Size in gallons 74 Manhole/Access (Y/N) YES "Pump on" level at 27.5 in. 'Pump oft" level at 16.5 in. High water alarm level at 37 in. Datum BOTTOM OF BASIN Cycles tested ' Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank 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 N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION o yr I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this Q date. Q •f� y..... arness:••Q Engineer's Printed Name JEFFREY A. GARNESS �0 CE -79 epi Date `+I2z-%o9 �4p',e •y (zz o`I�°°oo QQ °proresstolo4o ��4000�00 COSA Fee Date of Payment Receipt Number S (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ANALYTICA GROUP Gamess Engineering Group, Ltd. Attn: Jody GEG, Ltd. 3701 E Tudor Road, Suite 101 Anchorage, AK 99507 907-337-6179 Fax: 907-338-3246 Client Sample ID: S. Lakewood Hills Sampling Location: S. Lakewood Hills Client Project: Private Well Testing Sample Matrix: Aqueous COC It: Unknown PWS#: Residual Chlorine: Comments: Lab#: A0904118-0IA SP-Analytica, Inc. -Anchorage 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 Report Date: 4222009 Receipt Date: 4/142009 Sample Date: 4/142009 Sample Time: 2:00:00PM Collected By: Unknown Flat! Definitions: MRL = Method Reporting Limit MCL= Maximum Contaminant Limit B = Present also in Method Blank H = Exceeds Regulatory Limit M = Matrix Interference J = Estimated Value D = Lost to Dilution •• = RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 92236 -PA (Aqueous) - Coliforms in DW Test was conducted by: Analytica - Anchorage E. Coli Pass PASSIFAIL 1.0 1 4/142009 4/142009 DC Total Coliform Pass PASSIFAIL 1.0 ! 4/142009 4/142009 DC Lab#: A0904118-0IB Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate+Nitrite pres Test was conducted by: Analytica - Anchorage Nitratc-Nitrite as Nitrogen <MRL mg/L 0.10 10 4/16/2009 4/16/2009 JQ Lab#: A0904118-0IC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 200.8200.8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton Arsenic 3.37 ug/L 0.15 10 200.8 4212009 4212009 GY Page 3 of 3 4.. 6477 S 'COCA;.:) n VI 0 N 89-3*17 190-4)0, �44 ZMEMENITS CFR CORD, OTHER THAN I hereby certify that I have surveyed the following THOS_ SIiOWN N THE RECOROED _:'je OF 44 PLAT 0�41P described property. ME NOT 6 WN HEREON. % ke wr d q u kil Ali Anchorage Recording Precinct. Alaska, and that the improvement% situated thereon are within the property i'. -j WGIMIka kfe W lines and do not overlap or encroach On the Property lying adjacent thereto, that no improvements an prop - in NO. 325!4 4- �V Wo arty lyingadjacent thereto .encroach on the premises ,and visible easements an said property except ffon and that there are no roadways. transmission P/k,r '6V rsvcso esor as indicated hereon. i Dated at Anchorage, Alaska G6 lay of -Aup*4 19 this— �wm f zcalez 0, FRED WALATFLA d ASSOCIATES F13 74--f.. 70 Engineers and Surveyors■ 10 39Vd 'OSSI 'S V>UV-IVM GMIJ 180ZCVZL06 S0:z0 IZOZ/80/P0 At ■�■ Fron:ANCH TANK & MELDING INC ■ ■ ■ a XJIJ-10-2008 08:W -A FRW: 277 3715 04/16/2009 14:32 TD:18663947404 103 063 was ■■■ as ■ an ■■■ no was ■ Mel .� ■ ■ 11 ■o■■ one ■ ■ on on ■ an ■■ wes>o Ogg 8 3111111111111 was on III NEED 111111 Field Maintenance Report Inspection #323 P.001/001 P:1♦5 AnchorageTank & Welding, Inc. 907-272-3543 Dennis Webb p" (6-60 se. assess CoNat Ron. 6251 E. 112th Avc. Anchorege. AK 90516 907-712-3603 "InOws Carer Kir a... MENLO alab"vmi AX -100920 1 015-151-36 201005 RTU101355 04/152003 Retrieve O&M Imo Doig fbv♦ Steve ratio Tin.. m H1, 9e: Recirc Off Cycle Time-24.5/min Recrc On Cycle Time - 0.51min Perform Field SampikWObservatlona 1,lTUV5a MTV%) p" (6-60 DO C2-45) 7:3 Pmvtous n Odor of Sample. Willem ❑Must' LJEarao/ ❑Molar Non."Cal ❑SWnde ❑Cabbage 00seay Oiyrrlm InPW Oyes ONO FoawM tank ❑res ONO Cheek Control Panel Flecks amps Ducl.eiy. Mpa Iz 2 15' "It" and visual almma `U/ OK Diel tone gelemetry OrM gyri ONO Inspect/Clean Pump System Aupact Clean ItkerAw...................... Spooe Bov .................... l�l Fldet CMOs ................... Floats ........................ 1z B Pranp........................ Biatube Files ................. I Blotuba Pump Varat ............ .[}♦], ncolarent/kgn•�S(}g.�itt�er,V/a�h/rye�. �.�.�. �..` .�% 'its/fir' Comments l 4 ✓t ✓'�r�� % 4 Y�Ae Measure Sludge/Scum Mullins 1st CompWrum Cunem pe u% Crmrrt f ^ Pmvtous n r, a Intake V.nt ❑ (q' Inspect/Clean Disehanad Pump Sratem 2nd Compvbn.nt c+" Prevgya Curren previous Ri",AJd ❑ ' ❑y 31 H:c Pump ❑ Invpc V(clean AdvanTex Filter Odor. ❑NMmal ❑PurVent In4+acl latarals 0mves ❑ Clean ❑ Bunce ❑Npn w ❑ftwuo. I FedBottam n n addaine/PendlrlF ❑Nnnaratlrmr ❑F.Ca.awo Intake V.nt ❑ ❑ Inspect/Clean Disehanad Pump Sratem Inspect •., Impact Clean Ri",AJd ❑ Floe. .L ❑y spiiee Box Pump ❑ Mid surd. ❑ lnspeeUSerVICe Other System Components .. Impact Clean tnpeC't Clean Dmwtww% Equipment L]/ ❑ DEspemal t.ataals/OMkes ❑ ❑ VzCf.:' Observations D. =. 1 a� Additional Services Rendered ❑cki~ eirtm aAeetal ❑ Rapac-lid .1 w ot?w RomsT n Fapleoad W here%? Final/Safety Inspection �o., RSV mk.Malled �a�lids boned on ataratold reocnnactsd: Roes cal mil Hos1141,0 Ccrmcl parts n w.karlad Summa ry/R eeommerldations ❑hoatment aynern is parfani.m ❑Cd for servioe no Area action naeeuanJt C Unk needs twmping Date S 11-09' l—v9' rax eompleua corm zo -ir000-d84•T404 0 if ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND LO Saz,y-c2 THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this a� Day of ApLj of 20002, by and between L E/F 54-"Y6,oe— , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATAIENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Qua(-) located at5QU 111n&e ,*n fi,[(S *1 QLI 1 Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the OHncr to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of Q ($Q.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The tcrrn of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional FAluipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Rennin. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWXVTS. U. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: _Tw : C G A V C ae' C. Owner acknuwledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owncr agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AW WTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AW WTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AW WTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such parry thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terns and conditions of this contract, the only authorized representatives of the parties arc: Owner: LEtr Sp,,,4c(R— Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice or Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severabilitv. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: MUNICIPALITY: By: By Title: Date: y�2�1�`� Date: STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregom instrumffnt was acknowledged before me thisl71ti day of, 2001, by l?gm�ss NOTARI PUBLIC FOR ALASKA My Commission expires.�une ; 1 1, 1 oll Municipality of Anchorage Development Services Department ;` ►': Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us 9 7 343-7904 CERTIFICATE 0 HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING c Parcel I.D. 015-151-38 HAA# 1. GENERAL INFORMATION Expiration Date: Complete legal description SOUTH LAKEWOOD HILLS #1: LOT 6, BLOCK 4 Community Class Well ❑ Public Water System Location (site address or directions) 6251 E. 112TH AVE. • ANCHORAGE AK, 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JACKIE REPP Day phone 223-7694 6251 E. 112TH AVE. • ANCHORAGE AK, 99516 Unless otherwise requested, NAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 3701 E. TUDOR ROAD, SURE 101 s ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: in conducting this evaluation, AKWWC, inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. 337-6179 Date "/., " R Conditional approval for 4 bedrooms, with the fllowing stipulations: Jef WWI A. 1&Jss.' bll-7953 ;'�cpG �Q Profes810n� o� At the time of title transfer, the new property owner shall sign the attached maintenance agreement which shall be returned to this office before an unconditional approval is issued. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory ✓ Manitenance Agreements ✓ Supplemental Engineer's Reort Other By: Original Certificate Date: U ~ 3 D - 03 (Rev. 17/01) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 �' HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SOUTH LAKEWOOD HILLS #1 • LOT 6 BLOCK 4 Parcel ID: 015-151-38 j A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 10/7/1997 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 180 ft. Cased to 179.85 ft. Casing height (above ground) 24+ in. FROM WELL LOG Date of test 12/15/1997 Static water level 145 ft. Well production 12 —9-P.M. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.1' mg./L. Arsenic: 'N A mgJL. Date of sample: 8/4/2003 B. SEPTIC/HOLDING TANK DATA Tank Type/Material FlBERGLASS/S.T.E.P. Tank size 1500 gal, Number of Compartments E Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping NEW Pumper C. ABSORPTION FIELD DATABE�ow FiHnt cwi5El Date installed 1/29-30/2003 Soil rating p.d./f r 0bdrm) 3_0 AT INSPECTION 8/4/2003 144 ft. 7.5 g.p.m. Other bacteria 0 colonies/100 ml. Collected by: AKWWC, INC. Date Installed _ 1/29-30/2003 Cleanouts (Y/N) YES High water alarm (Y/N) YES System type SHALLOW TRENCH Length 42 ft. Width 5 ft. Gravel below pipe 0.5 ft. i Total depth 2.W+ ft., Eff. absorption area 210 ' rp ft Monitoring tube YES Depression over field NO Date of adequacy test NEW ResultsPass/Fail PASS ( ) , ; , . , For 4 bedrooms Fluid depth In absorption field before test = in.: Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= — g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NEW If yes, give date — I i D. LIFT STATION Date installed Size in gallons "Pump on" level at in. E. SEPARATION DISTANCES High water alarm level at in• Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway. parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed %%Name JEFFREY A. GARNESS Date oa F p� .. .. of re A. Gar s 7953 QP9s WQQ�Pf e s sloaG HAA Fee $ c 7 Waiver Fee $ Date of Payment to • Date of Payment Receipt Number L4 ��� < <— Receipt Number (Rev. 12/01) 08/04/2003 21:42 907-348-8931 PAGE 01 ALASKA WATER & WASTEWATER 10 CONSULTANTS, INC. WELL FLOW TEST DATA CLIENT: i NUMDBER OF BEDROOM: �' GALLONS PER DAY NEEDED 47" WELL; *SEE H.A.A. SITE VISIT CH CI LIST* DATE OF TEST: 1. Casing Height �( qve Ground): 2� 2. Sanitary Sea]:QC&8 NO (if "NO", describe in Comments) 3. Wires in Conduit: / NO (if "NO", describe in Comments 4. Water Samples Needed:/ NO if "YES", date taken: S. Depression around Well: YES / if "NO", describe {n Comments) 6. Does Well need Four Hour Flow est.(FHA): YES 1JjjW 1034�9/�i/o3 f nmm'nty A /,,Y� AA, W -Otrzv k,,6p " _ ac -e- - +v'� /44?"' v Signature: ��-tt�-/lL��yZ Date: 3701 E. Tudor Road, Suite lot 6 Anchorage, Alaska 99507 0 Ph' (907) 3376179 0 Fax: (907) 338-3246 0 akwwe.eom 8- 8-03; 9:24AM: ;907 5815301 # 2/ 3 SGS Rcf.# 1034829001 All Dates/Times are Alaska Standard Time Client Name AK Water & Wastewater Consultants Inc. Printed Date/Time 08/07/2003 15:00 Project Name!# L6 Blk4 S. Lakewood Hills #1 Collected Date/Time 08/04/2003 8:40 Client Sample ID 6251 E 112th Received Date/Time 08/04/2003 12:41 Matrix Drinking Water Technical Director �JStephen C Ede Released Sample Remarks: Parameter Qualifiers Results PQL Units Method CpnuAllowable Prep AnalysisinerID • iJmits Date Date Init Waters Department Nitrate -N Microbiology Laboratory Total Coliform 0.100 U 0.100 mg/L EPA 300.0 B (<=10) 0 coUt00mL SM189222B A (<-]) 08/04/03 JJB 08/04/03 JS