HomeMy WebLinkAboutSOUTH LAKEWOOD HILLS #1 BLK 5 LT 6uth
Lokewood
Block 5
Lot 6
#015-151-32
Municipality of Anchorage
Development Services Department '~;"~-- :::~-°'.
· Building Safety Division
On-Site Water & Wastewater Program, 4700 Bragaw St.
PoOp Box 196650 Anchorage, AK 99519-6650
www. ci.anchorage.ak.us (907) 343-7904 Page 1 of 5
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: aSP' ' . tF__.) / C__) .:~ ] P,D Nur~ber: 015-- 151 --:
Nome:
MARLA COLONELL Wastewater System: [] New I Upgr(~de
Address:
6401 E0 112TH, ANCHORAGE, AK, 99516 ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 546-5418 5 · Deep Trench [] Shallow Trench r-i Bed •Mound []Other
LEGAL DESCRIPTION ~i, Rating: Total Depth f ..... ,glnol grade:
0.45 GPD/Sq. Ft. 10 (MAX) Ft.
Block: Lot: Subdivision: Depth to pipe bottom from orlglnol grade: Grovel depth beneath pipe:
5 6 SOUTH LAKEWOOD HILLS #1 SEE DWG. Ft. 8.4 Ft.
Township: Range: Section: Fill added above original grade: Gravel length:
- - - SEE DWG.
Gravel width: Number of lines: Distance between lines:
WELL: [] New [] Upgrade 2.5 rt. 1 - Ft.
Classification (Prlvote, A.B,C): Total Dep.~3/ Cased To: Total obsorptlon oreo: Pipe moterlol:
/ Ft. rt. 1008 so. rt. D 5054/ F-810
Driller:. Dote Drilled: Stotlc Water Level: Installer: Dote installed:
Ft. PACIFIC SERVICES 5/27/2010
TAN
K
GPM Ft. Ft.
SEPARATION DISTANCES · Septic [] Holding [] S.T.E.P. [] Other*
T~To Septic Absorption Lift Holding Public/Private Manufacturer: Copoclty in gallons:
Tank Field Station Tank Sewer Lines ANCHORAGE TANK 1000
Material: Number of comportments:
Well 100'+ 100'+ - - 25'+ STEEL 2
Surface Water 100'+ 100'+ - - - LIFT STATION
Lot Line 5'+ 10'-{- _ _ _ Size in gallons: I Manufacturer:
I
Foundation 5'+ 10'-I- -- -- -- '"Pump on" level at: "Pump ~er alarm of.:
Curtain Drain - NONE KNOWN . Pump Marcel Inspections performed by:
I
Remarks: BENCH MARK
Location and Description:
*OLD TANK AND CRIB WERE ABANDONED IN GARAGE SLAB NEAR GARAGE DOOR,
PLACE PER UPC. NORTH SIDE OF HOUSE.
Assumed Eievotlon: 100.00 Ft.
ENGINEER'S SEA~
Inspections performed by: GE(:;;, Ltd. Dates: 1st 5/27/2010
2nd 5/28/2010
Development Services Department Approval
Conditional approval: D (]t:e:.
AS BUILT DRAWING
0SP101021 . 015-1
A B C
DBL1 12.07 - 20.30 ~
DB~ 11.43 - 21.33
ST2 56.32 85.73 - I
~ s~.~2 ~.~ -
DBL4 59.52 88.15 - /
C01 85.40 120.95 - /
MT1 83.96 119.14 -
C02 72.40 81.42 - ~
UT2 72.52 82.22 -t
I r Y--
/ "~ MT1 N~ 1000 GALLON
. / II ~SEPTIC TANK
~ ~DBL / ~::. ' ~
~ I~ ,-D~/ ~,~. :."j
II
/ :~~>,': .......
' ~ssU~Ea U~DE~ ~~, ::'
~,~,~ I / ".'. :... I
I / :':::.'":' ~---
~oo' wE~ ~us o
'
X 112th STREET
I
X SCALE:
X I
N 1"= 40'
3701 ~ ~R ~, ~ 101 · ~CH~E, ~ ~7 ~ ~ONE (907)337-61~ * f~ (90~-32~ * ~: m.go~in.~.com
P~EPA~[D ~0.: I PHONE NUUaE.: I PACE NU~E;:
MAR~ COLONELL I 907-346-3418I2 Of 3
LECAL D[SC~,PT~ON: DroWN BY:
SOUTH ~KEWOOD HILLS ~1; BLOCK 5, LOT 6 A.J.G.
AS-BUILT OF NEW SEPTIC SYSTEM 6/7/2010
(Rev. 01/05)
AS BUILT DRAWING
0SP101021 - 015-151-33
F2" INSULATION ·
/ fFINAL GRADE = 97.45.97.65
ST1 J J ST2
ToP oF TANK -X F1 / ~ ffl ~- TOP OF TANK
AT INLET = 94.18 ~ / -- ~ At OUTLET = 94.15
W 1000 GALLON
INVERT OF BUNG J I I SEPTIC TANK I I %-INVERT OF BUNG
TH# 1
FINAL GRADE = g5.7+,-.-~
MT CO INSULATION
ORIGINAL GRADE
O HIGHEST
POINT: 94-.80
FABRIC
OF PIPE
= 93.20
BOTTOM OF
TRENCH =
8.4-.80
RELATIVE ELEVATION OF BOTTOM
OF TESTHOLE = 78,80 (DRY)
GARN'ESS EN'GI'N'iEERING GiROU'P, :Ltd.
CONSULTANTS & GENE[~AL CONTRLt~CTORS
3701 E. TUDOR R~o SUITE 101 * ANCHORAGE. AK ~9507 * PHONE (907)337-6179 * FAX (907)338-3246 · ~/EBSITE: ~.gornesaengineering.com
PREPARED FOR:
MARLA COLONELL
LEGAL DESCRIPTION:
SOUTH LAKEWOOD
IPHONE NUMBER:
907-,346-3418
HILLS #1; BLOCK 5, LOT 6
PAGE NUMBER:
3OF3
IDRAWN BY:
A.J,G.
DATE:
7/1/2010
TYPE OF WORK:
PROFILE AS-BUILT OF NEW SEPTIC SYSTEM
(Rev. 01/05)
CE-
On-Site Wastewater Disposal System Permit
MUNICiPALiTY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP101021
Tax Code Number: 01515132000
Work Type: Septic Upgrade
Permit Effective Dates: May21, 2010 to May21, 2011
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: SOUTH LAKEWOOD HILLS #1
Site Legal Address: SOUTH LAKEWOOD HILLS #1 BLK 5 LT 6 G:2638
Owner/Address: COLONELL MARLA J
6401 E 112TH AVENUE ANCHORAGE AK 995161828
Site Mailing Address: 6401 E 112TH AVE, Anchorage
Lot Size In Sq Ft: 30341
Total Bedrooms: 3
Cpal'~ment
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N Pdvate Well N 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 wastewater code requires inspections dudng the installation. The engineer must notify the Development Services
Department at least 2 hours pdor to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to Apd115. a subsurface soil absorption system under construction during freezing weather must either.
A. Open and Close on the same day.
B. Covered. sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date: ~"'/~ ,~//~f~
o.~PI~IOO I
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
Anchorage, AK 99519-6650
www.cLanchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT .,~PPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-151-32
Property owner(s) MARIA COLONELL
Day phone 346-3418
Mailing address
6401 E. ll2TH DR * ANCHORAGE. AK
Site address Zip Code 99516
Legaldescription(Sub'd, Block&Lot) SOUTH LAKEWOOD HILLS ~1: BLOCK 5. LOT 6
Legal description (Township, Section & Range)
Lot Size Sq. Ft. Number of Bedrooms
THIS APPLICATION IS FOR ( [] all that apply):
Absorption Field []
Septic Tank []
Holding Tank ~
Privy
Private Well ~
Water Storage
THIS APPLICATIONIS AN:
Initial []
Upgrade []
Renewal []
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.
GARNESS ENGINEERING GROUPr Ltd.
Permit/Rush Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS" ~ ...........
May 10, 2010
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 EImore Road
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Reft Proposed Septic Upgrade for South Lakewood llills S/D #1/; Block 5, Lot 6,
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state
of failure and needs to be upgraded. We are proposing to install a new ! 000 gallon septic tank and a deep
trench type drainfield. One test hole was excavated on the property. The drainfield will be designed
around the 30 foot radius ofthis test hole. Comments regarding the design are summarized as follows:
I. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2, DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet ofthe proposed septic system.
4. TOPOGRAPllY: As can be seen on the attached design drawing the average topography in the area
of the drainfield is a 10-15 percent slope running approximately southeast to northwest. In short, there are
no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
C [l,~Gar e/~. ,P.E., M.S.
Pres!
NOTE: ,4ttached is a site plan drawing, a design drawing, one soil log. which are all part of the design package for
tltis septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite I01 * Anchorage, AK 9950%1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
J \ $OU~I LA~VOOD '1~ HILLS Jl OLO~K /' 'r~
I / I I \ / / I I
:/ I I \ \
, --- .7,..,~- '~' ~--~-----~----' , o
~ \ ~1 BLOCK ~ LOT ~ i i ~ iI
/
/ \ I
\ / LUND LOT 1
\ / ~ I I
GARNESS ENGINEURING GROUP, Ltd. ~[~¢1~ '".'..q~¢~
SITE PLAN OF' PROPOSED SEPTIC SYSTEId 5/10/2010
LETTER THAT pERTNNS TO THIS DESIGN.
~ALI.ONS PER DAY (GPO): 450 CONTACT GEG. BY PROCEEDING FORWARD
PERCOLATION RATE/S: 48 MIN/IN WITH THIS INSTALLATION, THE ENGINEER.
PROPOSED APPUCATION RATE: 0.4,5 WEll. ORIU.[R. CONTRACTOR AND
HAV~ READ THESE SP£CIFICATIONS AND
RAI F I . ~;RE[ TO ~CCEPY THE TERUS AND
CoNDmONS OUTLINED.
~4.0~. APPROVED SAND F']LT[R: N/A "'"~$.~ I ~ INSTAU~ DOUDL./ CLCANOUTS
EfFECTiVE: 8.5' -'uP'4~' / / P ~
FREDUCTION FACTOR: N/A / I ~ PRO OSED 1000 GALLON ,
A/.T[RNATE SITE ~ / / r-- ~ BE A~OONEO IN PLACE
NOTE'
DR~NF
ELD
S
· ~ WiLL REQUIRE / /
TO BE INSULATED I ADVANCED CO / / . . ,-- I~ND E:X~S~NG SE~C TANK
TR~TMENT-- - MTn9 / / I I/ AND ABA,NOON PER CODE
PROPOSED
, , / '"; ;.':" J
THE NORTH AND WEST PROPERTY ll2th STREET
LINES AND ALL WELL RADII FLAGGED \
BY A REGISTERED PROFESSIONAL LAND
\
SURVEYOR PRIOR TO CONTSTRUCTION
MAELA COLONELL I 907-546-5418 I 2 OF 2 [~^~:.tfi 1.,~.
GARNESS ENGINEERING GROUP, Ltd. '9I. ~_~..~?~,~
.=:
~Z ~ '. .... : ....
~o~ ~o~. ~ ~o~o~ ~,~: ,/~/~o,o ~.,::... .......... ...~
feet) ORGANICS JTEST HOLE ~lJ
SOIL C~SSIFICATIONS i ; ~ x
~ ~ I ~ J
2- ~JJ~JJ ~ j
'~"~b" GW ====: 0RG I I I ~ '~/
4 gJJFIJJ / CC OL ,
.... SW HH w I. l
SH 0H l
6-- SC I l
DEPTH TO l
I )11~;11 GROUNDWATER DATE j ] J~ ~x J,
[[[] DRY 5/5/2010 -~-
9-
11~ DATE READING CLOCK NET TIHE WATER LEVEL NET DROP
-- TIHE (HINUTES) READING (INCHES)
12-- ~ J ~'1JJ 5/7/2010 1 1:30 - 6- _
)11~11
2 2:00 30 5 3/8" 5/8"
13-- ,IJJ~ JJ 3 2:00 - 6- _
4 2:30 30 5 3/8' 5/8'
14-- ,~JJ ~ Jl 5 2:30 - 6- -
Jtlgll
6 3:00 30 5 3/8' 5/8'
15-- ~Jh~jl
/
TESI RUN BEIWEEN 5.0 FI. AND 6.0 FI.
20-- ~ A FOUR HOUR PRESOAK WAS PERFORMED: I YES D NO
SOILS LOGGED BY: ROB ~MPBELL PERCOLATION TEST PERFORHED BY: ANDR~ G~Y
COHHENTS:
PERFORMED BY GEG, Ltd. I. JEFFR~ A. GARNESS. CERTI~ T~T THIS W~,PEEFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
GI~ ER ANCHORAGE AREA BOROI ,
DI:vARTMENT OF ENVIRONMENTAL QUALIT,F
3500 TUDOR P. OAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
PHONE ,~$
SEPTIC TANK:
DISTANCE FROM WEI.L~'~
LIQUID CAPACITY
NUMBER OF
COMPARTMENTS
SEEPAGE SYSTEM: SEEPAGE PiT:
Z/ OR WlDTH___~ _, LENGTH .~2~ DEPTH
NUMBER OF PiTS ~/ OUTSIDE DIAMETER '
LINING MATERIA~~ ~ '/~ --~ '
~/~_ ~ ~. D STANCE FROM WELL_~~ BUILDING FOUNDATIO~,
NEAREST LO[ LINE~.-~/~~ TOTAl EFFECTIVE ABSORPTION AREA (WALL AREA) ~ SQ. FL
TILE DRAIN FIELD:
NUMBER OF LINES// DISTANCE BETWEEN LINES___--% __.TRENCH WIDTH
ASSORPTIO AREA __ SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE 10 FINISH GRADE_____ DEPTH OF FILLER MATERIAL BENEATH lite
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: T y p E _¢~¢~/-~-~;' , DEPTH c/
LOT LINE ~..~ NEAREST ~ SEPTIC
, SEWER LINE__ , TANK_
DISTANCE FROM WATER
, BUILDING FOUNDATION ..... z~-~ SAMPLE_
SEEPAGE
, SYSTEM__ ~:~ ,~ CESSPOOl
NEAREST
OTHER
SOURCES~''
DISTANCES:
DIAGRAM OF SYSTEM
G.A.A.B.
CHEMICAL & Gk~..~OGICAL LABORATORIES ,~ .,' ALASKA, INC.
TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER
274-3364 ~5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
I.D. NO.
Water System Name Phone No.
Mailing Address
Mo. Day Year
Zip Code
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref, no.
£3 Special Purpose
) [] Treated Water
[] Untreated Water
SAMPLE
NO.
L
L
5 I
LOCATION
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
~ Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
[] Membrane Filter
Lab Ref, No, Result* Analyst
I_ [-[-1 .,
*No ol colome$/I00 mi or No of Po$ilive porlions.
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev, 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
EMB. Broth 24 houri=
Multiple Tube Report=
Msml)r&ne Filter~ Direct COLInt
VerlNcatlon= LTB
Reported By
Cotlform/looml
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOFI
DEPAR'FMEN r OF HEAL'tH AND ENVIRONMENTAl_ PRO'FEC'rlON ,~ I
C.M. Winter
Star Route A Box 22-B
Anchorage, Alaska 99507
Subject: Lot 6 Block 5 South Lakewood Hills Subdivision
Approval for your individual
can not be granted until the
(~mpleted:
~ The water analysis report
be
delivered
to
this
office from Chem Lab, 5633 B Street, for our
review.
sewer and water
following items
facilities
have been.
Locate and expose the standpipe to the tank for
our inspection. This is to insure the minimum
distance requirements are met between your well
and sewer system.
T
he septic tank pumped with a receipt submitted
to this office.
/~ A~n~equacy test be performed on the existing leaching
area]. This test will ~etermine if the system is
~ adequate according to National Standards. A listing
~J~ J/o/~...private firms performing the test is enclosed.
\ ~/~his report needs to be submitted to this department
~ for. our review.
If there are any further questions, please contact this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: Sandy Hartman
Marston
August 1, 1980 R&M No. 051001-55
Mr. C.M. Winter
SRA Box 22-B
Anchorage, Alaska
99507
Re:
Adequacy Test on Existing Sanitary Sewer System; Consisting of a septic
tank with a seepage pit, Lot 6, Block 5, South Lakewood Hills Sub~
division, Anchorage, Alaska
Dear Mr. Winter:
Per your request of June 26, 1980, Philip R. Baldner of R&M Consultants con-
ducted a test of the sanitary sewer system on the above described property.
The test indicates acceptance rates determined under conditions at the time
tested. Actual system performance over long periods of time depend on
factors which cannot be evaluated by this test thus our office cannot warrant
the suitability or fitness of the system for either an extended period of
time or for user demand in excess of the expected flow noted herein. Factors
affecting system performance include:
Actual use demand on the system;
Fluctuations in groundwater levels;
Physical conditions of the septic tank, leach field, trench or
seepage pit and soil.
It should be noted that while a septic tank and leach field disposal system
is one of the most reliable methods of sewage treatment and disposal it is
nearly certain that the leach field or seepage pit will fail sometime during
the useful life of the structure. Studies indicate leach fields, trenchs and
pits have a life expectancy of ten to twelve years under optimum conditions.
All septic systems have a finite hydraulic loading capacity which can be
expected to decrease with time.
Because the house on the lot is occupied, we assume that the seepage pit was
at its normal degree of saturation. During this test the liquid level in the
septic tank was monitored as water was added to the system, The measurements
are summarized in on the following table.
Mr. Winter
August 1, 1980
Page 2
DATA & CALCULATIONS FOR SEEPAGE PIT TEST
SUBJECT: 3 Bedroom = 450 GPD Required Flow Project No. 051001-55
1. TIME OF PUMBER ARRIVAL: 2:00 p.m.
SEPTIC TIME SEEPAGE TIME GALLONS GALLONS GALLONS TIME
TANK PIT REMOVED REMOVED ADDED
LEVEL LEVEL FROM TANK FROM PIT TO PIT
2. 5.90' 2:08 5.60' 2:00
3.
4. 5.90' 2:22 7~90' 2:19
5.
6. 5.90' 2:32 5.65' 2:30
7. 9.70' 2:45 5.60' 2:43
1000
1000
I000
Return to lab and calculate specific capacity =
1000 divided (7.90'-5.60')(12 In./Ft.)= 36.23 Gal/In.
DATE: July 29, 1980
8. 9.45 2:47
6.20' 2:44
Calculate effluent acceptance rate based on specfic capacity =
(6.20'feet - 5.60 feet) (12 inches/foot) (36.23 gallons/inch) = 261 gallons
From: July 28, 1980 To: July 29, 1980
2:43 p.m. 2:44 p.m. = 24 hr. 1 min. = 1441 min.
1440 min./day 261 gallons + 261 Gallons Per Day
1441 min.
Mr. Winter
August 1~ 1980
Page 3
9. 9.45' 3:29 5.65' 3:27 200
Calculate measured effluent acceptance rate =
200 gallons From: 2:43 p.m. July 28,
200 Gallons X
1441 min. 1441 min.
200 gal. X 1440 min/day = 200 GPD
1980 TO: 2:44 p.m. July 29, 1980
Time: = 24 hrs. 1 minute = 1441 min.
SEPTIC TIME SEEPAGE TIME CUMULATIVE TIME METER
TANK PIT GALLONS ADDED READING
LEVEL LEVEL TO SEEPAGE PIT
10.
9.45' 3:29 5.65' 3:27 0 3:27
9.45' 3:45 5.45' 3:41 100 3:41
9.50' 3:56 5.20' 3:55 200 3:55
9.50' 4:12 4.85' 4:10 300 4:10
9.50' 4:27 4.55' 4:25 400 4:25
9.50' 4:42 4.30' 4:40 500 4:40
Date: July 30~ 1980
9.25' 2:35
9.25' 3:18
9.25 4:02
5.65' 2:32 0 2:32
5.00' 3:17 250 3:17
4.15' 4:00 500 4:00
Date: July 31, 1980
9.1' 3:00
5.65' 2:55
Mr. Winter
August 1~ 1980
Page 4
It! the 3 bedroom residence on the property is to house 6 people, the average
load on the system can be expected to be 450 gallons per day. During the
test, the system accepted 500 in 24 hours on two consectutive days.
We can therefore conclude that the system is disposing of effluent at an
adequate rate for a 3 bedroom residence.
We appreciate this opportunity to be of service to you. Please contact us if
you have any questions concerning this test or if we can be of additional
service.
Very truly yours,
R&M CONSULTANTS, INC.
Janice Cecere
Project Manager
Richard S Oiessel
Staff Engineer
JC/RG/jh/AT-R
0
GR~AT~,R ANCHORAGE AREA BOROUGH
Departra¢;nt of _~nvtronmenta] quality
3500 Tudor !~osd, Anchorage, Alaska 99507 279.8686
Date Received ~7- ~ U 7 ~ ,,
REQUEST FOR APcNOVAL OF
IND!\tIDIJAL SEi~;ER & dATEL FACI!,ITIES
9 Prooew%v ~lner
4, Loc~tton
Number of 3edrooms..
5. Well
C. Construct~ on
~' ~,' ? l le ~ ......
7. Sewage Disoosal o stem.
C. ~e~t~c Tank~ 1.
D. ~eepage Pit: 1. oize 2.
D. Bacterial Analysis
Insta 1 Jet
Manufacturer
Disposal Field:
To,'a] !,er. gth of Lines
D~stances:
A. Well To: ~er)t~c Tank , Absorpl;~.on Area /L)~-~/'/- , Sewer Lines
t./- /
B. Fo,]ndation +o S,,:-,kSc Tankt/ ;, t~b~orptton 'Area ................ ·
C, Aosorotio4 Are~ to Nearest Lot !.inc.._.. .-~ ~ __.~.
Request for Approval o ndividua] Sewer & Water Fac~.lit s
Pa ..qe Two
~0o!
~ { ..... ]f that the infrrma'.~m] .... - ~o
· com, a~ne. ].1 thl~ req~e.~t ~ ~ approval to be a true
and accu~tat~? repr(~entat:~r)q of t.h~, ~.-.'u':)iect sewer and water :~ac~.lit~es located at:
STATE OF
DE:' TMr!NT OF I~EALTll Al~tB 80CIAL
BACTEItiOLOGICAL WATER
MAT~IA~ ~ulldb~. ~e ...... 7~
~ ~ "=* ~ ~ ~ ~ W~ ~ ~t~. ~ ,. ~ ~ ~o~Io BroOm.
O~ER~, ~.... ~'~ ~ ~ype_~ ~emen~ ~ O, Con~ac your n .....
~.en~ ..... ~~ ~ '~ ~ANITARIAN,S REMA~KS
~ Ct Wol~ ~ O~hor ~
08-]220 (b) ' -
READ INSTRUCTIONS BACTERIOLoqlCAL WATER ANALYSIS RECORD
ON ~ -~ -~ ' ,
REVERSE SIDE 4~ ..... ~- ~ _~ ~ .....
COLLECTING ~AMPLE. ' -
REA BORodGH/~
ITAL QU ALITY{~
SF. WAGE DISPOSAL SYSTE~ -- APP .IC:ATIOM aNID~EP. MIT
NAME OF APPLICANT
~NSTALLATION OF: SEPTIC TANK //~
TYPe AND SIZE OF FACILITY TO ~E SERVED
GOMP~ETION DATE ANTICIPATED
~/ TO lBS INSTALLED bY
PERMIT NO,
OTHER
NOTE= THIS PERMIT I$ NOT VALID WITHODT SOIL TEST
FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEAl. TH DEPARTMENT AUTHORITY WILL BI" SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS
,;20 ~
DRAIN FIELD
20'
, DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, , SEEPAGE PiT
TO R]VER, LAKE, ST}~EAM.
SEEPAGE PIT
CAST IRON INTO ANO OUT OF SEPTIC TANK AND INTO CRIB GROSSING GAP OF
GRAVEL BACKFILL
CONFORM TO ~OROUGH REGULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
DIAGRAM OF: SYSTEM
L::~DT~:CE~mi:::IAL IC~R=:NHCT~i~::::~mC~NDTE: OF (~;REATERTC~H??~AGE A~EA BORC(~'G~ORDI~NCE NO. 28-68 AND THAT THE ABOVE
6-0
~UNICIPAL GE MUN[CIPALI1Y
( DEPARTMENT OF HEAL~ & ENViRONmENTAL PROTECTION
825 L Street - Anchorage. Alaska 99501
D~PT. OF
~NVIRONMENTAL
~' XTelephone264.4720 APi?I J Ig80
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all Darts o~ page 1. Incomplete requests will not be processed. Please allow ten (10) d~ys for processil3g.
1. ~ PRQNE
MAILING ADDR S
PRDPERTY RESIDENT ill different from
.~ PHONE
LEGAL DESCRIPTION~_ ~ ~ ,r
6, FYPEOF RESIDENCE
[~S~GLE FAMILY
[] MULTIPLE FAMILY
[~ INDIVIDUAL'
[] COMMUNITY
[] PUBLIC UTI LITY
8, SEWAGE DISPOSAL SYSTEI~I
[~1 N DIVI DUAL.rON-SITE~'
NUMBEROFBEDROOMS
[~] One [] Four
~_.o [] Five
[~ Three [] Six
[] Other
ATTACH WFLL LOG. A well log is required for all wells drilled
since June 1!}75. For wells drilled prior to that date, give well
[] PUBLIC UTILITY
de~th (attach log ' availableJ C~/-J~-- F'T-' .~ ~/~
''If individual/on-site, give installation uate /.,~7// .
If system is over [wo (2) years old aD adequacy test is reaulreo
by this Department.
NOTE: THE INSPECTION Fr~E MUST ACCOMPANY EACH REQUEST BFFORE PROCESSING CAN BE INITIA'rED.
72.010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIV',:D
INSPECTION APPOINTMENTS
TIME TIME TIME "
DATE DATE DATE
I NSP ECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[~ INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or [] Holding Tank
Size: I/! ~ If Tank is homemade SOILS RATING
give dimensions:
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sea, er Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[] APPROVED FOR BEDROOMS/)
E~] CONDITIONAL APPROVAL (letter must acgbm'pany certificate)
[~]/DISAPPROV ED ~_.~
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
Municipality of Anchorage
Devefopment Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF 0N-SITE SYSTEMS
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-151-;~
1. GENERAL INFORMATION
O
APPROVAL
Expiration Date: q- -ii
.2.
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
~ Mailing address
SOUTH LAKEWOOD HILLS S/D #1; BLOCK 5, LOT 6
6401 E. 112TH AVENUE * ANCHORAGE, AK * 99516
MARLA COLONELL Day phone ,546-5418
6401 E. 112TH AVENUE * ANCHORAGE, AK * 99516
Day phone
DONNA ORR W/ REMAX Day phone 240-7493
5801 CENTERPOINT DRIVE, #200 * ANCHORAGE, AK * 99505
Unless Otherwise;re quested, COSA will be held by DSD for pickup.
NUMBER.OF BEDROOMS: ,3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
ndividual Well · Individual On-site ·
Individual Water Storage [] Individual Holding tank []
Community Class Well [] Community On-site []
Public Water System [] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of 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.
C=
Municip ality of.Anchorage
Development SerViceS Department
CERTIFICATE
Legal DescriptiOn:
WELL DATA
Well ~pe PRIVATE
Date completed *,,,:1973
Total depth '210 ft.
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
OF ON-SITE SYSTEMS
!SOUTH LAKEWOOD HILLS #1; BLOCK
APPROVAL CHECKLIST
5, LOT6 Parcel ID: 0 J 5"'-/' 5'-'/- -~ 2...
*PER 197,3 REQUEST FOR APPROVAL DOCUMENTS.
**PER AAROW PUMP AND WELL INSPECTION. SEE ATTACHED REPORT.
If A, B, or C provide PWSID# N/A
Sanitary seal (Y/N) YES
Cased to.**40'+ ff.
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Well Log (Y/N)
wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
5/12/2010
106 .ff.
6.9 g.p.m.
NO
5/28/2010
YES
TRENCH
YES
24+ in.
Depression over field NO
For - bedrooms
New depth - in.
- g.p.d.
KNOWN If yes, give date -
Foundation cleanout (Y/N) *YES
Date of pumping NEW
ABSORPTION,;FIELD DATA
Date installed 5/27/2010
Length 60 ft.
Coliform 0 colonies/100 mi. Nitrate ND mg./L. Arsenic: ND ug./L.
Date of sample: 5/18/2011 Collected by: GEG Ltd.
SEPTIC/HOLDING TANK DATA *'DOUBLE CLEANOUTS BEFORE TANK.
Tank Type/Material SEPTIC/STEEL Date installed
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N)
Depression over tank (Y/N) NO High water alarm (Y/N)
Pumper -
~*BELOW FINAL; (~RADEI
Soil rating ~r ft%drm) 0.45 System type
Width 2,5 !ft, Gravel .below pipe
Total depth '10.9-1- ft. Eft. absorption area 1008 ft2 Monitoring tube YES
Date of adequacy test NEW Results (Pass/Fail). PASS
Fluid depth in absorption field before test - in. Water added - gal.
Elapsed Time: - min. Final fluid depth - in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE
8.4
N/A
LIFT STATION
Date installed
"Pump on" level at
in.
Size in, gallons Manho~
"Pump off" leve~ater alarm level at in.
Cycles tested.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Meets alarm & circuit requirements?
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas. 50'+
100'+ On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
N/A
100'+
Building foundation 5'+ Property line 5'+ .
Water main N/A Water service line. 10'+
Wells on adjacent lots 100'+
Absorption field
Surface water.
5'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation. 10'+
Water service line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
Water main N/A
Driveway, parking/vehicle storage
10'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
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
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 4 ~ ~ / I l
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
SCALE' 1"- 30'
LOT 4
S89°57'01"E 190.00
5' UTILITY EASEMENT
_ _ _ __10--CEA__EA._SE__MENT ..(BOOK 687, PG 967)._ _ __
Q~ o
Septic vents
°°o o
/
/
I
LOT 6
./
/
/
/
\
t
/
/
.> /
32.0
o. I Story Frame
Garage
32.0
Cleanout
deck
28.0
deck
m []
deck
o
o
28.0
- 37.7
Well O
--16.0-
· 16.5-
S89°59'00"E 190.00
E. 112th Avenue
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON.
Fb 10-=3, pg 3-4
8350F
30
30
AS-BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: LOT 6. BLOCK 5,
SOUTH LAKEWOOD HILLS SUBDIVISION,
ADDITION No. 1
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not ovedap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 1st day of JUNE ,2010
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
(907-248-1666)
Aarow Pump & Well Service LLC
(907)346-9355
Inspection Report
6401 E. 112th
Well camera ran down to 45'. No perforations found in casing. Well is constructed with 4"
threaded galvanized pipe. | can only assume well was drilled with mud. Pump is set at 156'. Due
to size of well casing we were unable to get a tape measure past pump. SWL is 106'
Brian R. Wille
Aarow Pump & Well Service LLC
SGSRef.# 1111945001 Y '~ L~__
Client Name Garness Engineering Group, Ltd Printed Date/Time 05/24/2011 8:20
Project Name/# S Lakewood Hillsq B5 L6 Collected Date/Time 05/18/2011 8:50
Client Sample ID S Lakewood Hills B5 L6 Received Date/Time 05/18/2011 11:05
Matrix Drinking Water Technical Director Stephen C. Ede
Sample Remarks:
Allowable ['rep Analysis
['arameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 05/19/11 05/23/11 NRB
Waters Department
Total Nitrate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 05/18/11 AYC
Microbiology Laboratory
E. Coil Negative 1 100mL SM20 9223B A 05/18/11 SD?
Total Colifbrm Negative 1 100mL SM20 9223B A 05/18/11 SDP
Aarow Pump & Well Service, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 - Fax (907) 333-8976
Eagle River: (907) 622-9335
N.e ' r~
CUSTOMER
r-.. ,.,
JOB SITE
-I F- 6 qOI ~-',!t~~. --]
r ,.;s,~.,u-~ ~.,~i ~ [ ...............
~BO~ ~ HOU~ ~ATE AMOUNT TOTAL MATERIAL
TOTAL LABOR
WOrK ORDERED BY DATE COMP. TOTAL
~BOR
PAY THIS AMOUNT
Thank You
91GNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work Is not patd for In gO days i agree to allow Aarow
Pump & Wall Sen/Ice, L.LC. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment,)
TERMS: ACCOUNT~ PAYABLE AT lOTH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1,5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.