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HomeMy WebLinkAboutWILLIAMSON #1 BLK 1 LT 22Williamson #1
Lot 22
Block1
#015-073-39
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231239
Work Type: Septic Upgrade
Tax Code Number: 01507339000
Site Legal Address: WILLIAMSON#1 BLK 1 LT 22 G:2437
Site Mailing Address: 5101 E 98TH AVE, Anchorage
Owner: LUGO HERMILO GOMEZ JR
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
�11ent
o S`'•
e
JWillr
De partinent
Lot Size in Sq Ft:
Total Bedrooms:
8/11/2023
8/10/2024
13919
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction. during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
1. The mounded cover is to have topsoil and be seeded.
2. The tank configuration may be (2) 1060 gallon tanks in series.
- eived � SSU P� to / A)A
Issued By:
Date:
Date: g �/
4
NWHMPAUTY OF ANCHORAGE
Development Services Department one: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICAI ION
Parcel I.D. 015-073-39
Property owner(s) Lugo Hermilo Gomez
Mailing address 5101 E 98th Anchorage Ak
Site address Same
Day phone
Legal description (Sub'd., Block & Lot) Williamson #1 B 1 lot 22
Legal description (Township, Range & Section)
Lot Size 13919 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
0
Initial ❑
Single Family (SF)
(w/wo ADU)
Septic Tank
El
Upgrade El
Duplex (D) EJHolding
Tank
ElRenewal
1-1Multiple
Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. i further certify that this is in accordance with
applicable Municipal Codes.
o
(Signature of property
Permit/Rush Fees:
er or authorized agent)
Date of Payment: Xy //Z3
Receipt Number: 0 4 q'3 Z7
Permit No. 0 S P Z 31 7 S J
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231239, Deb Wockenfuss, 08/11/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231239, Deb Wockenfuss, 08/11/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231239, Deb Wockenfuss, 08/11/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231239, Deb Wockenfuss, 08/11/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231239, Deb Wockenfuss, 08/11/23
Wockenfuss, Deborah M.
From: Tim Ecklund <oldnailbender@hotmail.com>
Sent: Thursday, August 10, 2023 6:38 AM
To: Wockenfuss, Deborah M.; Noffsinger, Ross D.
Subject: FW: Tim Ecklund
[EXTERNAL EMAIL]
If they put this on a letter head will this satisfy the MOA?
Sent from Mail for Windows
From: Reza Shams
Sent: Thursday, August 10, 2023 4:30 AM
To: Tim Ecklund
Subject: Re: Tim Ecklund
Here you go
Sent via the Samsung Galaxy A52 5G, an AT&T 5G smartphone
Get Outlook for Android
From: Reza Shams
Sent: Tuesday, August 8, 2023 8:18:47 AM
To: Tim Ecklund <oldnailbender@hotmail.com>
Subject: RE: Tim Ecklund
Hi Tim,
It was good to speak with you yesterday. As we spoke, our recommendation for tank sizes for BioBarrier g 0.5 to achieve
BOD/TSS removal is different than that for TN removal. Below is a summary that you could use with regulatories.
® BioMicrobics recommends two equal volume (1,000 -o -al or greater) tanks when BioBarrieru -0.5 is designed to
achieve low effluent BOD/TSS/NH3-N/Fecal Coliform and partial TN removal. The first tank is for settling and
the second tank is for treatment where membrane unit is located.
® BioMicrobics recommends 500 -gal settling tank followed by two -zone 1,500 -gal treatment tank for BioBarrier®
0.5 designed for TN removal. The first zone of the 1,500 -gal treatment tank is the anoxic zone and the second
zone houses membrane unit.
Reza Shams, Ph.D.
Vice President, Advanced Process Technology
BioMicrobics, Inc.
Ph: 913-422-0707
Fax: 913-422-0808
rshams@biomicrobics.com
www.biomicrobics.com
Welcome to BioMicrobics.com, where Architects, Builders and Property Owners can find useful information advice insights
resources and inspiration for "Better Water Management."
1
r
MUNICIPALITY OF ANCffORAGE
s r
jell MCf
n -HS MAINTENANCE AND REPAIR AERR
GREFNT, herein the "AGREEMENT" made and
entered :into as of this _ Day of A —1 tit f of 20,13, by and between
L11qV �2., , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. AgHUA Wagowater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as
a-A01&a&-
I
locate
at (legal description)
2. Maigiggaugg, Regairs 1Wd Alteratlan
(Clymer is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agteement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AVMTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(&), replacement costs, and inspection costs. This
includes an annual maintenamce fee (typically $400 to $600).
P i_..r Owner agrees that only maintenance and repair persunnol approved by tbo Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
t- .i.. Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
.�.. Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordatice with AMC 14.60.030.
(� Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
� �. L Owner agrees that any We or transfer of title of the property will not occur without a new
Certificate of tin -Site Systems Approval_
K- L Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jarisdiedon: Chgia of Law. Any civil action arising from this Agreement 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 Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
STATE OF ALASKA
IMMIM M: 61�
Date:
) ss.z PUBLIC>w
The foregoing instrument was acknowledged before me this
202-5, by
NOTARY LI OR ALASKA
My Commission expires: Cr4.
MUNICIPALITY:
By: _._. _signature}
.siiki•. i��
(print name)
Date: / y
Title:
(rev. 05118/2018) Page 3 of 3
Mark Begich
Mayor
bevetopment Services E)epartment
Building Safety bivision
On-Site Water & Wastewater Program
4700 Bragow Street
P.O. aox 196650
Ancho~ag~, A~ 9951%6650
,,vww.muni.ora/onsite
(907) 343-7904
Well Drilling Permit Number: SW
Pump Installation Log
Date of Issue:
Parcel Identification Number:
!Legal Description
/ t L
Property Owner Name & Address:
Pump Intake Depth Below Top of Well Casing'.ffO feet
Pump Manufacturer's Name: ~) ~c~
Pump Model: ~'5/~
Pump Size ~_._hp
Pitless Adapter BurialDepth: l~) feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: ~
Well Disinfected Upon Completion? ~Yes [] No
Method of Disinfection:
Comments:
Pump Installer Name:
Anchorage Pump & 'v'v'~il S~,
330 East 76th Avenue
Anchorage, Alaska 9951
Phone: 907-243-0740
Fax: 9~:)7=243-0742
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Municipality of Anchorage Page__1 of 2
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 54-5-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW990158 PID Number: 015--075--,39
MARK WILLEY Wastewater System: [] New [] Upgrade
Address:~
2021 LOCUST COURT ONTARIO, CA ABSORPTION FIELD
Phone: No. of Bedrooms:
,~ [] Deep Trench [] Shallow Trench [] Bed [] Mound Other
LEGAl. DESCRIPTION .o,, .o,,.~, ,o,o, O.p,~p~o~o.,nm
GPD/Sq, Ft, Ft.
Lot: 8lock: Subdivision: Depth to pips bottom from original grade:R yth beneath pipe.'
22 1 WILLIAMSON #1 . rt.
WELL: [] New [] Upgrade,..,/~ sQ. ~i°noYsl widU~, Ft Number of lin.a:
TANK
SEPARATION DISTANCES u Septic = Holding B S.T.E.P,
From Tank Held StoUon Tank s~w.r u... ANCHORAGE TANK 4000
WaR - - 75'+ 25% STEEL 1
SurfdCeweter - - ~oo'+ LIFT STATION
Found=Uon - - 5'+
Cu~ain N~NE KNOWN -- ~,p~tl~* ,~"~
Drain I
Remarks: ~. ~C~ ~[ ~'. ~ BENCH MARK
10~.6~ n.
~ O~ ~1
Depa~ment of Health and Human Se~ices approval '~¢.U '... -~ ·
PERM,T HUMBER: AS BUILT DRAWING PAROE'
SW990158 ' 015-073-39
., A B C J D / ~ TH#1zb_~
~01 ~.1 b.7 _-- i -- / ~ ~ ~ ~ OLD SEPTIC
302 - - 57.3 j49.9 / .. ~ ~ J ~ANK. CRUSHED
~RM~ - 44.3 50.1 / TH¢2~ ~ ~ /~ AND FILLED.
~03 - : 50.4 51.4 ,/
"~L~~ ~A~N ~H~~©
PHONE: (907) 337-6179/F~: (907) 338-3246
WILLIAMSON SUBDIVISION ~1' LOT 22, BLOCK 1
..........
AS-BUILT DRAWING OF HOLDING TANK UPGRADE
PREPARED FOR: PHONE NUMBER: ~.' %, J C
546-5798
MARK WILEY (907)
K,D.W, 1 = 50' 2 OF 2
~ B C D
301 35,1 5.7_- I -
302 37,3, 49.9
~,LARM 44.3 50.1
;03 50.4 51.4
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 995~9-6650
(907) 343-4744
ON-SITE WAS'I'EWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jun 21, 1999
Expiration Date: Jun 20, 2000
Permit Number: SW990168
Legal Description: WILLIAMSON #1 BLK 1 LT 22
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: Mark Wiley
OwnerAddress: 2021 Locust Court
Ontario, CA 91761-0000
Parcel ID: 015-073-39
Site Address: 005101 VALLEY VIEW DR
Lot Size: 13919 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[~ Disposal Field ~ SepticTank [] Holding'rank [] Privy
[] Private Well [] 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 ( 1OAACS0 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 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:
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B N Anchorage - Alaska 99504
Phone (907) 337-6179 ~ Fax (907) 338-3246
Cousulting Engineers
JUNE 7, 1999
Municipality of Anchorage
Department of Health and Human Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Reft Sewer Upgrade for Lot 22, Block 1, WILLIAMSON #1 S/D. HOLDING TANK
To whom it may concern:
The existing 3 bedroom house is se~wed by a private well and a septic system that consists of a
1000 gallon septic tank and a trench type drainfield that is surcharged and in ground water.
Three test holes were excavated on the property. Grotmdwater was found in all tln'ee holes (see
attached soil logs). The groundwater appeared to be traveling just below the organic layer. Based
upon our assessment of the site, it is unlikely that there is any suitable accepting soils (2 feet
unsaturated), as required to install an onsite septic system.
It is our recommendation that your department allow us to install a 4000 gallon holding tank.
The tm~k will be located approximately 50 feet west of the existing septic tank and 80 feet away
from the ~vell. A copy of the proposed design is attached. If you have any questions, please
contact us at 337-617'
TRACT 2B
WlLMOTH PARK
~t~.L. Ii COMPLE~'ELY.
~OQ ',/~6ACL
O~ HOLDIB6 TANK
LOT 19, BLOCK
WlLLIAMSON S/D ~'1
LOT 18, 8LOCK I 1
WILLIAMSON S/0 ~1I
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
690~ DEBARR ROAD SUITE 28, ANCHORAGE, AK 99504
PHONE: (907) 337-6179/R~X: (907) 338-3246
LEGAL DESCRIPTION:
WIL. LIAMSON SUBDIVISION i~l, LOT 22, BLOCK 1,
~(PE OF WORK:
SITE PLAN FOR SEPT]C UPGRADE
PREPARED FOR: PHONE NUMBER:
MARK WILEY 346-$798
~)ATE:6/7/99 O~WN BY: SCAt. E: PAGE:
J.L,M. 1 = 100' 1 OF 1
:-7953
OLD SEPTIC SYSTEM
TO BE ABANDONED
COMPLETELY.
~H#I
PROPOSED 4000
HOLDING TANK.
I
/
CO
LOT 23, BLOCK 1
WlLLIAMSON S/D #1
FOC
/
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
BgD1 DEBARR ROAD, SDIIE 213. ANCHDRAOE, AK. B9504
PHONE: (907) 337-BI79/FAX: (907) 33B-3249
PHONE NUMBER:
(907)345-.3798
LEGAL DESCRIPTION:
WILLIAMSON SUBDIVISION; LOT 22, BLOCK 1,
TYPE OF WORK:
SITE PLAN FOR SEPTIC UPGRADE
PREPARED FOR:
MARK WILEY
DATE:6/7/99 DRAWN BY: ISCALE: PAGE:
K.D,W, 1 = 50' 1 OF 1
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
~o E. c~s~ ,~S. mc~ * ^~C,O,A~E, ~. ~0~~__~.. "~
LEGAL DESCRIPTION: WlLLIAMSON SUBDIVISION ~1; LOT 22, BLOCK 1,
PERFORMED FOR: MARK WIL~ ~..~
~EPTH ~
feet)
.:::~SLI ORGANICS
i~~~:~ ~(~ ..... so'g C~SSIFIOATIONS
2
~ 3 .~/~ i. (,, ?,~i (SA]-URATE p) ~ ~ ::::::-¢~ /
~) ?.~?e ~ SEPTIC
6 HL ~C~ sc
VER NSE
DEPTH TO DATE
3ROUNDWATER J
'rEST HOLE
...... LOCAT,ONS A~
APPROXIMATE
~H) 3'9' 4/6/994/2/99~ ~R~O~Ti~ ~S~ ~E~5~
DATE READING CLOCK NET TIHE WATER LEVEL NET DROP
TIHE (HINUTES) READING (INCHES)
PERCOLATtON RATE (~IN./INCH) ,/PERC. HOLE BIA. ~ (INCHES)
~ TEST RUN BETWEEN - ,FT. ~7 FT.
.CT O.-S,= S .T,C
2 FE~ OF UNSATURATED ACCEPTING SOILS. HIGH TECH/(INNO/~ ~¢~T~ AT BEST.
PERFORMED BY A~SKA WATER ~ WASTEWATER I, / ~ ~ , CERTI~ THAT.
THIS WAS PERFOR~E~IN ACCORDANCE WITH ALL S~A~I¢, JN~GUIDELINES IN EFFECT ON THIS
DATE. DATE:
DEPTH TO DATE
3ROUNDWATER
_. 9'. ..... 4/2/9B
3' 4/6/99
ALASKA WATER & WASTEWATER CONSULTANTS, IN_C.
7520 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504
[SO}L LOG - PERCOLATION TEST}
LEGAL DESCRIPTION: WlLLIAMSON SUBDIVISION ~1; LOT 22, BLOCK 1, ~'-'~' ...............
DATE PERFORMED: 4/2/99
[~s~ ,o,~ ~ "~;:c''~ ............ ";&~
1 ~ ORGANICS
4~}'=:L,FINE SAND (WET) FY/~2'-~ GC -F-rF'r¢ OL i%~7
~ 'rSST HOLE _ ~(,/ % i 1
/ LOCATiOnS A~ ~ t¥' % / I
~0~ ~PPROX~UATE
~ ~ATE READINO CLOCK NET TI~E WATER LEVEL NET VROP
~ TI~E (~INUTES) READING (INCHES)
19~ PERCOLATION RATE - (HIN./INCH) ~PERC. HOLE DIA. - (INCHES)
20~ TEST RUN BETWEEN - FT. AND //¢ FT.
.CT .*.C
/ ///~/ ~/I
.~.~o...~ ~ .~.. w.=~ ~ W*.=WA=R ,,( .~. / . , c...,~ ~.AT
THIS WAS PERFOR~E~ IN ACCORDANCE WITH ALL ~ ~D~QPA~ELINES IN EFFECT ON THIS
~A=..A=: ~/~/~? ¢/ ~/ ~¢
DEPTH TO DATE
3ROUNDWATER
SEEFS ~ 5' .
3' 4/6/99
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
7320 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504
PHONE (907) 337-6179 * FAX (907) 538-5246
[SO L LO0 - PERCOLATION TESTI
LEGAL DESCRIPTION: WILLIAMSON SUBDIVISION ~1; LOT 22. BLOCK 1,
PERFORMED FOR: MARK WILEY
DATE PERFORMED: 4/9/99
ORGANICS
ITEST HOLE #3I
FILL
ORGANICS
SP
HL
DENSE
ATURATED
SILT
SOIL CLASSIFICATIONS
OR
ML
CL
OL
M~-
CH
DEPTH TO DATE
GROUNDWATER
7' 4/12/~9
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
NO PERCOLATION TEST PERFORMED
PERCOLATION RATE - (MIN./INCH) PERC. HOLE DIA. - (INCHES)
TEST RUN BETWEEN -
COMMENTS: NOT SUITABLE FOR ON-SITE SEPTIC SYS~/.E :¥/~
, TPHEIRsFOwR,~E~EBRYFCRLAb~'K4INW'~TcEcRoF~2AcSETEwWIfHTE,~LII' ~,-Z/~TE~
L BATE.BATE: ¢/3/~'~' ,/ / ~,/
, AND
FT.
, CERTIFY THAT
;UIDELINES IN EFFECT ON THIS
) MUNICIPALITY OF ANCFIORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-47;~0
ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELL INSPECTION REPORT
~ = '
DISTANCE TO: Iw~ Abs ° r P~r~r e? Dwollint~ *
Liq. cl~gallons IF HOME.DE: ,nsidelength WiOt,~~ : -- Liquid depth
DISTANCE TO: Well Dwelling PERMIT NO.
Manufacturer Material Liquid capacity in gallons
Well Founda)iol I Neare~ Io~i,e PERMIT NO.
"o. of ,in.~ ~~ Total le,~f lines Treno~i~h Distance be~*, lines
~ inches ~tal ef fecti,v~%~ption area
f tile to finish grade Material beneath tile M,¢' inches Z/~~'
Lengtb Width Depth PERMIT~O.
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line PERMIT NO,
Buildin~ foundation Sewer line Septic tank Absorption area(s)
DISTANCE TO:
OTHER
PIPE ,~ALS .~ -- . ~O'~
I
72 (Rev. 3/78)
FI. II~ i.ENI:!i'FH [::, !: t"IF~;N~}:; :[ CIH :IX'i!; 't'H~}: L.E::H(:i'Fll ,::XH I:::F:[i:T::, CIj::
'l'l'iE I)EZF'TII I:)1:: 1::t TI;i:EHI::::II I:ll;~: F':[i' ~'.!i:; 't'I"IE [::[:[~ii;'l'!:'ll",ll:::ii:
GI:;::OI..i[',!I:::, FIl",!l:::, TILE: fi:li:i'l't'l::)l"t Ol':: Ti-Iii; I:}::;:.::l:::l':D/l::l'l~'l:l:::lN r:
't'l~[}:l:~:[i}: :l:~ MI:il ~;~!:F I.,.!:H:::"I"H F'OI~:
H'l!:!: Cii;:'.t:::lb'l!i:L. [::,E:F"IH :[::i; Tl.llii: H :!: N :I H[ .IH E:,E:F:'Tt'I Cfi:: I:::il;~:l::t',,,'Ii}:l.
F:Ii",[[::' TI'ti!: li::l::l'l'l'l.:)l'"t CiF:' 'l'll[:!: Ii:::,:',Cl':l',,,'r~T]:l)i',f ,::]:[.,I I:'.'[!1;::'!';:,,
AItCTIC fi[JBARC ! ~(
LliY' ~ ~ I0
MICHAEL. B. BERG, MA'BI , .c' 6 NSULTANT
AG'
Mr. Kenneth Simpson
P.O. Box 10-1648
Anchorage, Alaska 99511
Rf!CEIVED
June 12, 1979
Subject: Soils investigation for sanitary sewer system on Lot 22, Block 1, Williamson
Subdivision, Anchorage, Alaska.
Dear Mr. Simpson:
At your request of June 6, 1979, I conducted a soils investigation at the proposed
location of s sanitary sewer system on the subject lot.
This investigation, which was accomplished on June 7, 1979, consisted of the inspection
of soils removed during the digging of a 11.0 foot deep test pit, using a wheel mounted
bacM~oe.
The soils encountered are graphically shown on the accompanying test hole log. The soils
consisted of a series of interbedded sands, silts and sandy gravels. The soil column and
the interrelationships of the strata are shown clearly on the test hole log.
A water table was encountered at 7.5 feet while digging. It consisted of a small seep that
grew somewhat with time, but still less than 1 gallon accumulated in 30 minutes.
The topography of the lot consists of a northerly facing hill dropping to a relatively flat
area on the northern most portion. A profile of the lot on a line in a northern direction
is included with the location sketch.
Vegetation present on the lot consisted of common tall spruce and birch, with some alders
and willows and a low ground cover of mosses and grasses.
An accompanying sketch shows the subject lot with the approximate location of the test
pit in relation to the property lines.
The area where the system will be located will have 3 to 4 feet of fill placed over it
after construction of the drainfield. This fill will come from the spoil derived from
the removal of soil from the hillside at the construction site.
I appreciate the opportunity to be of service to you. Please contact me if you have any
questions regarding this soils investigation.
Very truly yours,
Attachments: Drawing of test hole log with location sketch and lot profile sketch.
xc: Department of Health and Environmental Protection
VaYm ~ 30'
A r. 4~
5' power
Easement
Lot 22
/Williamson Subd.,
/Anchorage,
Proposed well
location
Utility Esmnt
I
N53°00'00"E 120.32' I
A'
NOT TO SCALE
Distances are approximate and have not
been measured by surveying methods as
to test hole location.
Lot topography profile along line A-A'.
NOT TO SCALE
Profile is approximate and was not
defined by surveying methods.
Michael B. Bergmann
Consulting Geologist
Box 191, Star Route A,
Anchorage, Alaska 99502
(907)344-9150
T.H. No. 1
6-7-79
0.0'
anics & Organic Silt: sl
--%moist, loose, brn.
and: pred fn to med, fair
sorting, sl moist, loose,
grybrn.
(sP)
3 0'
w/some Gravel, Sand
pred med to crs, moist,
loose, dk grybrn.
%_--(SW)-- .....--- 4.0'
nterbedded Sands and Silts
approx 3"-6" thick. Sands
are fn to crs. Silts contain
a low trc Clay. Sl moist to
vy moist, loose to med dense,
discontinuous, grybrn.
(SP to ML)
----7.0'
(GW)
.5' WD & AB
Sandy Gravel: w/occ cobble, med
dense, moist to wet, grybrn.
w/low trc Clay, med dense,
"k sl moist, grybrn.
~ (ML)
andy Gravel: w/occ cobbles,
dense to vy dense, moist,
some thin silt layers, grybrn.
(GW w/some ML)
ll.0"TD
Water encountered @ 7.5' while
digging. After 30 min. less than 1
gallon had seeped into test pit.
Test Hole Log represents soils encoun-
tered on Lot 22, Block 1, williamson
Subdivision, Anchorage, Alaska.
·
MUNICIPALITY OF ANCHORAGE
Department Services
Development De w 1
P P ��� ' � Phone: 907-343-7904
On -Site Water & Wastewater Section �' rFax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 015-073-39
1. GENERAL INFORMATION
Complete legal description WILLIAMSON #1 BLOCK 1 LOT 22
Expiration Date: -1 r oL.-1 _Z0
Location (site address) 5101 E 98TH AVENUE, ANCHORAGE, AK 99516
Current property owner(s) MICHAEL T. BLOMQUIST Day phone
Mailing address
Real estate agent
5101 E 98TH AVENUE, ANCHORAGE AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
Day phone
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
❑
Water Storage
❑
Holding Tank
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for:
Received by:
Distance:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5,bz - Yeo? -S-b
Date of Payment & (I al a 0a6
Receipt Number &o02 / D S
COSA# a5 C ;?U / ez48
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
COVID-19
25% DISCOUNT APPLIED
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 6/8/2020
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the ^.► A[
system and maintenance. The operational life of all well and septic systems are subject to � p� • ' • 1A Q``l
these various and dynamic characteristics and are outside the control of the evaluator of the �••' :1f
well and septic system. Therefore, any estimate of how long a system will function satisfactory/* • ,tn TH
for current or future occupants or guarantee that no unseen encroachments, deficiencies or `� — ••* r
discrepancies exist can be given by First Water Consulting & FWM � • • • • • • • • • • • • • •
1 �_
• • .
6. DSD SIGNATURE Curtis Huffman
�� �F� •, CE 128991 ,• �w
System #1 Approved for „3 bedrooms•¢/8/2020 ,.•��
System #2 Approved for bedrooms 1\�pROFEWROFESSIONP
Disapproved
Conditional approval for bedrooms, with the following stipulations:
Original Certificate Date: '-2a ^ Zo
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory 0ther e,,q ez
s
Legal Description: WILLIAMSON #1 BLOCK 1 LOT 22 Parcel ID: 015-073-39
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DATA
® Well log is filed with Onsite (or attached) Water storage tank volume NA gallons
Date drilled 8/16/1979 Well disinfected for coliform test? ❑ Yes ® No
Total depth 60 ft ® Coliform bacteria is Negative
Cased to 60 ft Nitrate *13.7 mg/L ❑ Nitrate less than MRL (ND)
® Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND)
® Wires are properly protected
Casing height (above ground) 18+ in. Collected by F
ES
Date of flow test for COSA 6/5/2020
Static water level at beginning of test 23 ft. Date of Sample 6/5/2020
Well production at time of test 6+ gpm
Comments *SEE SULLIVAN SCOPING LETTER.
B. TANK DATA
Age of tank(s) 21 years
Tank type/material HOLDING TANK /STEEL
Measured operating fluid level in septic tank
® Standpipes/foundation cleanout per record drawing
Date of pumping 5/18/2020
D. ABSORPTION FIELD DATA
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A —pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments: See attached L&S inspection report &
comments on second page. SEE MOA ADVISORY.
Adequacy test date
Results ❑ Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth _ in
Elapsed time min
❑ Code -required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies: FW!rS
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ❑ Yes
if No 75'+ ft
Neighboring Absorption Fields > 100'
Water Service Line > 10'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100' ® Yes if No _
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100' ® Yes if No _
Water Main > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No _
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No —ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
ft
ft
ft
ft
ft
ft
ft
See attached CEA non-obiection letter for well in electrical easement Holding tank integrity and functionality appears
normal based on observations (consecutive day fluid level measurements) L&S inspection and correspondence / tank
pumping schedule from A+ Services.
G. ENGINEER'S CERTIFICATION
1 certify that / 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.
low
TH
• ' Curtis Huffman
�� ��G' •. CE 128991 .• 4`��
iIP,F'p0 6/25/2020 R
��� pROFE3StONA .,�
DEVELOPMENT SERVICES DEPARTMENT a �
On -Site Water and Wastewater Section
www.muni.org/onsite
Molding Tank Advisory
Certificate of On -Site Systems Approval #OSC 201248
Subdivision: Williamson #1 lot 22
907-343-7904
Fax: 343-7997
Starting at 20 years of age the MOA issues Advisory's for steel septic/ holding tanks. The Holding
tank for this property is 21 years old. Typical replacement costs range from $12,000 to $15,000.
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of what the metal of a 20 year old steel tank MAY look like.
� 4 � MaiUng Address P O Box 196650 * Anchorage, Alaska 99519 6650 *www murn org � � t
DEVELOPMENT SERVICES DEPARTMENT tl
On -Site water and wastewater Section
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC 201248
Subdivision: Williamson #1, Block: 1, Lot: 22
907-343-7904
Fax: 343-7997
A water sample revealed a nitrate concentration of 13.7 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
r Mailing Ac�clress' P O Box 196650* Anchyorage, Alaska 99519 6650 *www muni org x
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
,� Ma�hng Address �P O Box 196650 *Anchorage; Alaska 99519 �6�0'� www murn org
Date: 6-10-20
P.O. Box 670269 Chugiak, AK 99567
P: (907) 688-2759 F: (907) 688-2259
TO: Brent Western
5101 E. 98th Ave
Anchorage, AK 99507
Camera Inspection Report
Ran camera down to 50’. Once camera reached the water the clarity made it difficult to see. Left for 3
hours to let it settle. Upon return, clarity was better but still limited. No perforations or breaches were
visible from what we could see.
MUNICIPALITY OF
Development Services Departments
On -Site Water & Wastewater Section
Phone: 907-343-7904
Fax: 907-343-7997
14V-DtvG-- 1,-4,vX,
Maintenance Lag
Owner Street Address_ %() f As 918 b n
Phone Legal Desc. PID
Septic Tank: �,q
-Sludge level inches -Pumping: requiredey s no -Pumping completedey s no
Lift station:
-Pump basket cleaned yes no -Effluent filter cleanedey s no
-Control floats cleanedey s no -Proper float settings confirmedey s no
-Operation satisfactoryey s no
Alarm System:
-Dedicated electrical alarm circuit es no -Audible and visual alarm inside dwelling es no
-Alarm system operationatisfacto not satisfactory
Manhole Riser N10
-Ground water intrusion at riser to tank connectioney s no
-Ground water intrusion around pipe penetrationsey s no -Weep hole functional Ves no
-Manhole lid: Functionalery_s no Insulated yes no Properly Securedey s no
Other
-All manufacturer required inspections and maintenance completed es no
Comments:
...... ._.... ......�..._` �N&N ..... "G, . ..... .�..a.... .........
.........9. tiX�.�.....C. ......:�.e')r4T1a
................................ .................................................................................... ................................
Maintenance Provider:
Technician �� �T ! I S Date of maintenance - t50y ' os�J
Company S 5e dV1ce5
Signature Date t} yo
sic>ii�ii�:e_�•ic��=t-r�a mm r®-1v.�rl�A�rJ.� :ie
d�
SURVEY ORDERED BY:
R4'-' tNALL En:
a XEI, fR lil t f�M''
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES A14D PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEtiENTS, OR FENCELINES.
EASEMENTS OF RECORD,OR ANY LEGAL ENTITY, OTHER THAN THOSE APPEARING ON THE RECORD PLAT
ARENOT SHOWN HEREON( UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DET'ERMNE
PROPERTY L.NES OR POSITION ADDITIONAL IMF-ROVEMENTS.
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EEXCESSIVE SNOW AND/OR ICE.
AS-BU/LTSURVEY i- =3o,
PJO CORNERS SET THIS DATE
I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
10T.2 6LOCK 1, .lOLLIAdLSONADD'N 1
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE,ALASKA THIS 67H DAY OF
IUNf , 2020
HOLT LAND SURVEYING
'�-E LF ✓EY Cti TA GI HIS n°.4V/SG IS PRFiAADF0R T/1E 0✓1,VF OFFECORD CNL Y 9309 GROVER DRIVE
ANY G YInGORVTH✓/tX T/FVATA cCNISP.'O//lPl7EDt IdI fR COI'/A (l7 L; N✓ ANCHORAGE,AK 99507
14646, FE204-61 345-5513
2020 -02691 I -O
L Recording Dist: 301 - Anchorage
S 6/26/2020 02:45 PM Pages: 1 of 4
IIINIIIII9III�I�I�II�II�I��I�III��I�R�IIVIPI�II�I�R''���IIIIIIIII'IIIIIIII
1203-15A
Grid 2437
EN20010
015-073-39-000
ENCROACHMENT PERMIT
This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative,
(herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Michael T.
Blomquist (herein "Permittee"), whose address is 5191 E. 98`h Avenue, Anchorage, Alaska 99516.
1. Easement. Chugach is the grantee or user of an easement for the construction and
maintenance of electrical facilities, as follows:
Described in that certain written instrument recorded on the 14' day of March 1988, in
Book 1714, Page 309, on file in the office of the District Recorder, Anchorage Recording
District, Third Judicial District, Seward Meridian, Alaska,
Dedicated by the plat of the subdivision known as Williamson Subdivision Addition No. 1,
according to Plat Number 70-192, recorded on the 27`h day of July 1970, on file in the
office of the District Recorder, Anchorage Recording District, Third Judicial District,
Seward Meridian, Alaska,
(herein "Easement") which pertains to the following described real property:
The West Five Feet (W 5') and the Southerly Ten Feet (S'ly 10') of Lot Twenty-two (22),
Block One (1), Williamson Subdivision Addition No. 1, according to Plat Number 70-192,
recorded on the 27t11 day of July 1970, on file in the office of the District Recorder,
Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska.
Permittee acknowledges the validity of the Easement. Permittee warrants and represents that
Permittee is the owner of the fee simple interest in the land subject to the Easement and the
following described real property to which the Easement is adjacent:
Lot Twenty-two (22), Block One (1), Williamson Subdivision Addition No. 1, according to
Plat Number 70-192, recorded on the 27`h day of June 1970, on file in the office of the
District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian,
Alaska,
(herein "Parcel")
Encroachment Permit - Page 1 of 4
eRecorded Document
2. Encroachment. Permittee has constructed or purchased the following improvements
on or within the real property subject to said Easement:
A well that encroaches approximately One Foot (1') into the cast side of said Easement
along the west property line; for a distance of approximately One Foot (1'), AND a
retaining wall, which is made of paver blocks, that encroaches approximately One Foot
(1') into the northerly side of said Easement on the southerly property line, for a
distance of approximately Forty-five Feet (45),
(herein "Encroachment")
3. Permit. Chugach hereby authorizes Permittee to continue the existence of the
Encroachment in its existing location subject to the covenants set forth in this permit.
4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any
claims for personal injury, property damage or other loss arising in any way from the continuation of
the Encroachment.
5. No Expansion or Increase. Permittee shall not in any way expand or increase the
extent to which the Encroachment occupies any of the real property encumbered by the Easement
without the prior written consent of Chugach. Chugach has no obligation to provide such consent.
6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the
Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in
the future give rise to any interest or estate in the real property subject to the Easement or any other
real property. Without in any way limiting the foregoing, Permittee acknowledges that the
Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the
permission of Chugach for purposes of the common law doctrine of adverse possession. This permit
creates no interest in the real property subject to the easement.
7. Modification of Utility Facilities. If the electric utility facilities located within the
Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of
Chugach's total costs for such modification which is reasonably attributable to accommodating or
preserving the Encroachment. If such payment is not made within thirty (30) days of written
demand for same, Chugach may terminate this permit in accordance with paragraph 9, below.
8. Covenants Running with the Land. The obligations of the Permittee arising from this
permit shall be covenants running with the land which shall burden the Parcel and the Permittee's
interest in the land subject to the Easement and. shall benefit the Easement.
9. Termination. Chugach may terminate this permit after the giving of thirty (30) days
written notice of such termination if:
Encroachment Permit - Page 2 of 4
2of4
eRecorded Document 2020-026911-0
a. The Encroachment is enlarged, increased or extended within the real property
affected by the Easement.
b. The Encroachment is damaged by any means to an extent of more than thirty percent
(30%) of its replacement cost at the time of destruction.
C. Permittee fails to make the payment described in paragraph 7, above.
10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years
from the date hereof.
11. Entire Agreement. This written permit constitutes the entire agreement between the
parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous
agreements, oral or written, between the parties. No modifications, amendments, deletions,
additions or alterations of the permit shall be effective unless in writing and signed by all of the
parties hereto.
CHUGACH ELECTRIC ASSOCIATION, INC. PERMITTEE
Shelly Schmit enior Manager Michael T. Blomquist
Date: i "� C} �� Date: _ �- Ze2
Encroachment Permit - Page 3 of 4
3 of 4
eRecorded Document 2020-026911-0
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this PVii' iay of�- ,
2020, by Michael T. Blomquist.%
STATE OF ALASKA
ss:
THIRD JUDICIAL DISTRICT
i
Notary Pub in and for the State of Alaska
My commission expires: X1-6;11 2z
The foregoing instrument was acknowledged before me this 4j day of
12020, byV_
Senior Manager, Distribution Engineering of Chugach Electric Association, Inc.,
an Alaska corporation, on behalf of the corporation.
AFTER RECORDING RETURN TO:
Chugach Electric Association, Inc.
P.O. Box 196300
Anchorage, Alaska 99519-6300
o ary Public`m and for the State of Alaska
My commission expires: d �-:'i-ZZ
Encroachment Permit - Page 4 of 4
4of4
eRecorded Document 2020-026911-0
CNUW1MC::
POWERING
June 25, 2020
Michael T. Blomquist
5101 E. 98"' Avenue
Anchorage, Alaska 99516
Subject: Letter of Non -objection for Fence within Easement
Lot 22, Block 1, Williamson Subdivision Addition No. 1
NEV, of Section 15, T12N, R3W, S.M., Alaska
01320013, Grid 2437, MOA I.D. #015-073-39-000
Dear Mr. Blomquist:
Chugach provides its non -objection to the existing wood fencing within the easement areas on the
west and southerly sides of the above referenced property, as shown on the As -built Survey by
Holt Land Surveying, dated June 6, 2020.
It must be your understanding that the installation of the fence in the easement area is at your risk,
and Chugach's future use of the easements may require you to relocate the fence and/or provide
access across the property for the servicing of Chugach's facilities.
This non -objection is given without prejudice to Chugach's full enjoyment of any and all rights it
may have in and to such easement areas.
Enclosed for your use and information is the 811 Alaska Dig Line utility locate call center card,
and Chugach's What is an Easement? handout.
If you have any questions, please call Claudia Roberts, Right -of -Way Agent III, at 762-4646.
Sincerely,
Karen Keesecker
Manager, Land Services
Enclosures
Chugach Electric Association, Inc.
5601 F_lectron Drive, ?O, Box 196300, Anchorage, Atosko 995196300 • !9071563-7494 Fax 190711562-0027 • 1800; 478-7494
wm,vchugacheleciric.com • inio2chu9ochelectric.com
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Lot 22; Block 1; Williamson Subdivision #1
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailin. g address
Mark Willey
C/O Dynamic
501 E. 98th Avenue
Anchorage, AK
Properties Attn:
Day phone
Patty Seymour
Day phone
Agent pa~y Se_ymot]r/Dymaml ~ Prop~r~i ~s
Address '~111 "C" Street Suite 100 Anchorage
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
XX
Day phone 261-755~
AK 99503
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
xx
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I furtherverify 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 com/pliance with all Municipal and State codes,
ordinances, and regulations in effect
Name of Firm
Ad dress 690,1' DEB
Engineer's signature
on the date ~f//t1~is inspection.
~ / i~l(J . Phone ~
/ Date / 2//~t_ ¢
Wastewater Consultants, inc.
Shall be PAID ~._. at,
or prior to. ', '
c,~,smg for the
Engineerh;9 .... ~..
,~e, v,ce~ Provided,
6. DHHS SIGNATURE
Approved for
bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Note: The well for this property meets existing State and Municipal Codes.
There are nqtrnff~ pr~nff. Tf- 4~ ~.5g~sJ?a ~ p~riodic testing be--
performed to insure the wells continued suitability. Current nitrate
More information on nitrates is available from the On-site Services Program,
Additional Comments
By:
, . JR
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA ~21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
A. WELL DATA
Well type PRIVATE
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Health Authority Approval Checklist
WILLIAMSON S/D #1; LOT 22, BLOCK 1 Parcel I.D.:
60'
015-075-39
IfA, B, or C, attach ADEC letter: ADEC water system number
N/A
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform 0
Date of sample: 12./7/99
B. SEPTIC/HOLDING TANK DATA
Date installed 7./1 ¢J./CJ¢~
Foundation cleanout (Y/N)
Date of Pumping NEW
YES Date completed 8./16./79
Cased to 60' Casing height (above ground) 18"+
YES Wires properly protected (Y/N) YES
FROM WELL LOG AT INSPECTION
8/16/79 7/20/99
25' 24'
7 g.p.m. 7 g.p.m.
Nitrate 5.95 mo/L Other bacteria 10
Collected by: A.W.W.C., INC.
Tank size 4000 Number of Compartments 1 Cleanouts (Y/N) YES
YES. Depression (Y/N) NO High water alarm (Y/N) YES
Pumper -
C. ABSORPTION FIELD DATA ~
Date installed Soil rating (g.p.d./fF or fF/bdrm) S~__ __
Length _Width __ Gravel thickness below pipe ~ Total depth
absorption area__ __ Monitoring Tu~epression over field (Y/N) __
Effective
Date of adequacy test__ ~ass/Fail) __ For___ __ bedrooms
Fluid depth in aborn.); Immediately after gal. water added (in.):
Absorption rate
Fluid depth ~ (ins) Minutes later: = g.p.d.
~nt (past 12 months) (Y/N) If yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION '
Date installed _ Size in~_______
Manhole/Access (Y/N) "Purrj,~el at* "Pump off" level
High water alarm level at* ~~ *Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot 75'+
On adjacent lots
100'+
Absorption field on lot
Public sewer main
N/A
N/A
On adjacent lots
Public sewer manhole/cleanout
100'+
N/A
Sewer/septic service kine
25'+ Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+ Absorption field N/A
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Building foundation Water~E_~~
Surface water ~ng/vehicle storage area
C~ Wells on adjacent lots
F. ENGINEER'S CERTIFICATION/,,
Signatur~%/F~~ % - ~~~', ~.. .*~
Engineer's Na~e,/. /~ / JEFFR~ A. GARNESS
Date /~,~ ~ - ·
HAA Fee $ Waiver Fee $
Date of Payment
Date of Payment
Receipt Number
Receipt Number __
72-026 (Rev. 3/96)*
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D.
CER'FI'FICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
01 5-073-8'6~ .1,c~ _ HAA # I~/,%%c~
1. GENERAL INFORMATION
Complete legal description ;Lot 22; Block 1; Williamson Subdivision #1
Location (site address or directions) 501 E. 98th Avenue
P~operty owner Nark Wiliey
Mailing address 2021 Locust Court Ontario,
Day Phone~94Lg~__9_~0
California 91761
Lending agency I::)ay phone
Mailin. g address
Agent Day phone
Address
2. NUMBER OF BEDROOMS:
3, TYPE OF WATER SUPPLY:
Unless otherwise requested, HAA will be held for pickup.
NOTE:
Individual well xx ¢
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal s~s~sr~S~a~J;n~liance with all Municipal and State codes,
ordinances, and regulations jn effect o.n the.. date Q.f',fl~js ir]_spection.
wastewarer uon ul an , ....
Name of Firm / *~-6-~--!, ~BarrAg/~, ~;~ 'YA Phone
Address ,," /7,,A ?d//~,/CAK /~ / /
EngineeCs signature /~/~' (~"~~ Date
///
DHHS SIGNATURE
/.-/ Approved for
-'~-/1/ RE g' bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
~ote: ~he weJL1 for this property meets existing State and Hunicipal Codes.
performed to insure the wells continued suitability. Current nitrate
More information on nitrates is available from the On-site Se~ices Program,
~mo, 3~3-47~.
Additional Comments
By:
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
Mur, ici pality of Anchorage
DEPARTMFNT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 b Street, Room 502. Anchorage, Alaska 99501.
Health Authority Approval Checklist
Legal Description:
WILL.lAMSON #1; LOT 22, BK 1
Parcel i.D.:
015-073-56
A, WELL DATA
Well type PRIVATE
Log present (Y/N)
Total depth 60'
If A, B, or C, attach ADEC letter, ADEC water system numoer
YES Date completed .~..
Cased to 60' Casing height (above ground)
N/A
33"
YES
Sanitary seal (Y/N)
Date of test
Static water level
YES
FROM WELL LOG ~
25'
Wires propeny protected (Y/N)
AT INSPECTION
7/20/99
24'
Well production 7 g,p,m. 7 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 _ Nitrate 5.57 rn~J/L Other bacteria
Date of sample: _ 7/20._~/99 Collected by: AWWC, INC.
B. SEPTIC/HOLDING TANK DATA
Date installed 7/19,/99 Tank size 4-000 Number of Compartments
Cieanouts(Y/N). YES
· Foundation cleanout (Y/N) YES
Depression (Y/N)
NO High water alarm (Y/N)
YES
Date of Pumping NEW Pumper N/A
C. ABSORPTION FIELD DATA
Date installed
Length Width
Effective absorption area__
. Soil rating (g,p,d./fF or fF/bdrm) System type ¢/
Gravel thickness below pipe ~...Tetal~pt'"'h
Monitoring Tube present (Y~epression over field (Y/N) _
Flesult~;~'~'~'il~~'' For
gal. water added (in.): _ __
Absorption rate = .g.p.d.
If yes, give date
Date of adequacy test _
Fluid depth in absorption fleld~~'-(in.); __ Immediately after
Fluid depth _ .~--'~ (ins) Minutes later:
~de treatment (past 12 months) (Y/N)
bedrooms
72-026 (Rev. 3/96)*
LIFT STATION ~
Date installed Size in gallon~s
Manhole/Access (Y/N) N/A "Pu~ "Pump off" level at*
High water alarm level at* ~ *Datum
E. SEPARATION DISTANCES
F.
SEPARATION DISTANCES FROM WELLON LOT TO:
· ~ieff~eiholding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
75'+ On adjacent lots 100'+
N/A On adjacent lots 100'+
N/A Public sewer manhole/cleanout
25'+ Lift station N/A
N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation 5'+ Property line 5'+ Absorption field
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 75'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line
Surface water
Curtain drain
Building foundation .~
~ Driveway, parking/vehicle storage area
Wells on adjacent lots
ENGINEER'S CERTIFICATIO~,~/
in conformanye wit? HR yH~ gui
Engineer,s Nam~~ ~
Date
lines in effect on this date.
JEFF OARNESS
HA&Fee $
Date of
Payment ~¢:~'~'~/~..~-- ~//~ ¢
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES /~/
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
'~0~0 ~_. 264-4744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED RRIOR TO SUBMITTAL)
'
~.~..~ ~..d~ block, subdivision, section, township, range)
(a) Legal Descrip c lot,
Location (address or directions)
(b) Prope~y Owner ~,
Mailing Address
(c) Lending Institution ~..r~. ~ [g Telephone
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
Telephone: Home _~[/'b~ '~7'~,-_ Business ~,.~- ~../~"~
(e) Mail the HAA to the followino address: or: Check here,,~ if hold for pick up.
List contact person and day phone number below.
TYPE el" RESIDENCE
Single-Family~
Number of Bedrooms
WATER SUPPLY
Individual WellXl~ Community [] Public []
Note: I~ community well system, must have written confirmation from the State Department oI Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
' Onsite~ Public [] Community [] Holding Tank []
Note: I1 community well ~ystem, must have written confirmation trom the State Department of Environ mental Conservation
attesting to the legality and status,
Page 1 of 2 72-025 trey 8/861 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 fifes 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 ~ ~ Telephone
Address
'1/
DHHS APPROVAL '
Approved for ~.,~ bedrooms by .... Date
Approved ~ Disapproved Conditional
Terms of Conditional Approval
r&
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 72-025 fRev 8/86) Back
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4744
Legal Description:
Well Classification
Well Log Present (Y/N)
If A, B, C, D.E.C. Approved (Y/N) I~/~
_ Date Completed °°//~'/7¢/' Yield ~>~ ~¢4~
Cased to _/~- ¢
Total Depth ~ ¢
Static Water Level
Casing Height Above Ground -,~
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot /
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
/k/O/~//~,7 To Nearest Public Sewer
~ O/"J L~' To Nearest Sewer Service Line on Lot
'~-'~ ~,, _ ;Date I c~lcl [~
To Nearest Edge of Absorption Field on Lot /O'(p 4-
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
7
SEPTIC/HOLDING TANK DATA
Date Installed ct/le /'7 *i
Standpipes (Y/N) ~
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
Size IO¢---~%~ __ No. of Compartments
Air-tight Caps (Y/N)
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
Foundation Cleanout (Y/N)
Date Last pu ~nped I 0/~'~/~ 7 "~,'~..,~' _
;for
Temporary Holding Tank Permit (Y/N)
To Building Foundation ~ '~
To Disposal Field I i2)
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026 fRev 8/861 Fronl
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well /
To Building Foundation / /
Lot /~/0/%/~
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line I ~
To Existing or Abandoned System on
; On Adjoining Lots .~ ,"~ ~;~
To Cutbank (if present) ~/O~ E
Comments
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify th.~.ve checked, ve~ifie~ o~ conformed to all MOA and HAA guidelines in
Signed ,/ ~, ~ Date /O - ~.,¢.~ , ~"~
1
Company MOA No.
effect on the date of this inspection.
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
Engineer's Seal
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
RESIDENTIAL
WELL INSPECTION
LEGAL:
LOT 22, BLOCK 1, WILLIAMSON
LOCATION:
5101 E.98TH.
OWNER:
MATTHEW McENENY
TYPE OF WELL:
SINGLE FAMILY
WELL LOG AVAILABLE:
YES
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD FROM WELL LOG:
25 GALLONS PER MINUTE
PUMP YIELD:
7 GALLONS PER MINUTE
DATE OF INSPECTION:
OCTOBER 19, 1987
TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 7
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE.
THE WATER LEVEL WAS FOUND TO BE ~$__TH'AN 25 FEL ~ BELOW TOP OF
CASING, LESS THAN THE MINIMUM READING DISTANCE FOR THE PROBE.
AF~F~T~ MINUTES~F_~ELMP~L THE DISTANCE TO THE WATER LEVEL WAS
STILL LESS THAN 25 FE~. A TOTAL OF 600 GALLONS WERE PUMPED
TEST FOR C~OL/LF~QP~MS AND NITRATES: OCTOBER 20~ 1987
E. COLI 0, ~I?~R_~TE_~S. 5~/~1.~ 10 (a:Llowable)
TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE
THAN FOUR HOURS
The Municipal requirement for well flow is
150 ga[Llons of water per bedroom Der 24
hours.This well surpasses this requirement.
The assessment of the condition of this well
applies only to the conditions as of this
date. The flow rate of the well may change
due to subsurface conditions that may not be
observed from the surface, and changes
land use and other factors that may impact
the co~ditions of the aquifer feeding the
well.
~ ~ ~ ANCHORAGE, ALASKA 99501
CONSULTING ENGINEER TELEPHONE: (907} 279 3916
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM:
LOT 22, BLOCK 1 WILLIAMSON
51.01 E. 98TH AVENUE
MATTHEW McENENY
FAM C ,
PRIVATE, ON SITE
FROM MUNICIPAL RECORDS:
TANK: GREER STEEL, TWO COMP.
ABSORPTION SYSTEM: TRENCH
ABSORPTION AREA: 435.SQ.
SOIL RATING: 145
INSTALLATION DATE:
1000 GAL.
FT.
SEPTEMBER 1979
DATE OF PUMPING: OCTOBER 20, 1987. MARX ENTERPRISES
DATE OF TEST:
OCTOBER 19, 1987
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND
WITH FOUR FEET OF COVER AND A LIQUID DEPTH OF 47
INCHES. SOUTH TRENCH SUMP WAS 87 INCHES DEEP AND HAD A WATER
DEPTH OF ~8 I~NC~H~. NORTH SUMP WAS 58 INCHES DEEP AND HAD A
WATER DEPTH OF .10 [L~[~S. WATER WAS ADDED TO THE SOUTH SUMP AT A
CONSTANT RATE OF 7 GALLONS PER MINUTE WHILE THE WATER LEVELS IN
THE TWO SUMP WERE MONITORED. THE ADDITION OF 600 GALLONS CAUSED
THE WATER LEVEL IN THE SOUTH SUMP TO RISE,~~S, AND THE
LEVEL IN THE NORTH SUMP 9 INCHES. THE INFILTRATION RATE WAS
MONITORED FOR 50 MINUTES. DURING THIS TIME THE WATER LEVELS
DROPPED 2 INCHES IN'THE SOUTH SUMP AND 1.5 IN THE NORTH SUMP,
~C~7~'~'-K~S'~O~' RATE OF MORE THAN 100 -G~~ PER HOUR~
TEST RESULT:
THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system rill continue to meet the operational requi-
rements of the Municipality and State.
MUNICIPALITY OF ~aNCHORAGE
DIVISION OF ENVIRONM_ENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONM~]NTAL PROTECTION
APPLICATION FOR }rEAL[CH AUTHORITY API>ROVAL CERTIFICATE
(a) Legal Description (include lot, block, subdivision, section, township, range)
(b)
Locatioa (address or directions)
Applicants Name
Business
Applicants Address
(c).Applicant is',(check one) Lending Institution ~.~; O~m?~/builder ~_~ ;
(d) Lending' In~6iltut~on Telephone
Address
(e) Real Estate Co. & Agent
Address
<f)
Telephone
Mail the HAA to the following address:
~7P? of Residence
Single-Family ~
Number of Bedrooms'
blulti-Family ~--~
Other (describe)
Water Sup?ll
Individual Well ~ Community ~-~ Public
Note: If community well system~ must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
s e
Onsite ~/~-- Public [--~ Community ~_~ Holding Tank~--']
Note.' /fir community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
.Engineering Firm Providi~?ctions~ Tests~ File Search_z, 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 herain. I further verify that,
based on the information obtained from the M~nicipality of Anchorage files and from my
inv.~tigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
DHEP ApjTr oval
Approved for'?~&~
Approved /~ Disapproved
Terms of Conditional Approval
GA~£ION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF I~ALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTNORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. T~ ~tEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES ~ND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-84
Be
, MUNICIPALITY Of:
DRPL OF IJEA~'~ &,
ENVIRONMENTAL PF~OTkCI'ION
MUNICIPalITY OF ~CHO~GE (MOA)
· H~ A~HORITY ~PROV~ (H~) ~0V !
CHEOKLI~ - .FEBRU~Y 1984 R [ C [ i V[[ D ,
~LL raTA megal Description: ~7~
Total ~pth ~¢~ z Card to
~ ' ~pth of Grouting
Casing Height ~ Ground.~ ~.~/ Sanit=y ~al on Casing~)
Electrical Wiring in Condui~N) ~presszon ~ound ~l~ead
. Sep~ation Distance f~ ~1:
To ~ptic/Holding Ta~ on ~q /F~/~' ; ~ Adjoining Lot~
To ~arest Edge of ~sorption Field on Lot /~9<~ fi; On Adjoining ~ts
To Nearest Public ~r Line ~ _ To Ne~est Public ~r
Clean~t/Manholq ~ ~ To ~a~est ~r ~rvice Linp on ~t
water Sable Collected By ~J~ ; ~>e
SEPTIC/HOLDING TANK DATA
Date Installed ~/:~ . Size
Standpit~s/~)-- Ai~-t ight Caps.)
No. of Compartments >._
Foundation Cl~nout ~/N )
Pumping/Maintenan~ Contract on File (Y/N) /g//~ ; for.
Holding Tank High-Water Alarm (Y/N) i~/~- %%mporary Holding Tank Permit (Y/N)/O~__
Separation Distances from S~ptic/Holding Tank:
To Water-Supply Well _
To Property Line
To Water Main/Service Line .~-
Course qb I O O/~-'
To B~ilding Foundation~/~-
To Disposal Field ~-0 '
To Stream, Pond, Lake, or Major Drainage
Receipt ~
Date Paid
Amount:
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~/~
Width of Field ~ ~ /
Square Feet of Absorption A~ea
Depression over Field (~)~)
%__.-
Results of Last Adequacy Test
Tm of System sign
Length of Field ~_
Depth of Field
~ravel ~d Thickness
I~ ~ ~ ~ .....
~te ?f ~st A~qua~ Test
Separation Distanoe from Absorption Field:
To Water-Supply Well /~/./6 To Property Line ~ /
To Building Foundation /I I To Existing or Abandoned System on
Lot /t3/~ ; On Adjoining Lots .~--
To Water Main/Service Line -~ /// To Cutbank(if present)
To Stream/Pond/Lake/or Majo~ Drainage Course .~/~ /
To Driveway, Parkirx~ Area, or Vehicle Storace Area 2 5~ ? .~
LIFT STATION
Date Installed ~__ D~ ns~ons
Size in Gallons a/~: ~~(Y/N)Leve.~:
"l:h.~p On" Level at ~"',~p Off"
High Water Alarm level Vent (Y/N)
Tested for ng Cycles du~ing Adequacy Test. Meets YDA
Electrical Cod~s ('~'
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, o~ confor~ed to all MOA IU~R Guidelines in effect
on the date of this inspecticn.
Signed ~,'~ ~Y~"''~
KB1/d5/s
~,OA NO. S~/-O~,?
[Page 2 of 2]
2-15-84
ALASKA PJiUIROFImeF1TAL CO ITROL Sel dlCES, IFIC.
Enqi~ri~ 6 ~nui~onmcnbl $1u~lics
October 19, 1984
Department of Health and
Environmental Protection
825 L Street
Anchorage, Alaska 99501
Attn: Keith Bandt
Legal: Lot 22 Block I Williamson Subdivision
Well Flow Test on Single Family Residence
Dear Keith:
A flow test was performed on the well at the above property on
October 18, 1984. The static water level was at .-21.73'.
Over 450 gallons of water was pumped at a rate of 6.5 gpm with
a drawdown of 0.32'. The recovery time was 10 minutes.
I consider this well adequate for domestic useage in this 3
bedroom house. Please contact me if you have any questions.
Approved:
Sincerely,
ironment al Scientist
1200 LUcsl 33rd Aucnue. SuiI¢ ~,Anclmro§e. Alosko 99503,{907) 561-5040
~? 'APPLIC. rr FILLS OUT UPPER HAL' 3NLY
~ · 2 k ~ ~ (>, ,~ Phone
~dd~ ~::;*-'h~ ;~ c .~'~ .... ,,,,.~ ~ ~ 7:>,
~ Community t~ Fo, wells driiled prior to that date, givewelldepth(attachloglfav.llable),
~lndlviOual = Year I.OiWdual Installed: ~(~['~'t C-.
Time Time Time Time
Inspector Inspector Insp6ctor Inspector
Field Notes;
//~?../~) MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
/--~...,~,~ ENVIRONMENTAL p~OT~CTION
~- AUG ~ '19E;3
RECEWED
( ~ ) APPHOVED BEDrOOm8 'OONDITION8 OF APPROVAL
( ) DISAP~OVED
( ) C~N~ITIO~AL APPROVAL'
DATE _~~
ALASKA SeRUICeS, IIqC.
eI1UIROFImeFITAL COrlTROL
~n~Jn¢~rJnq $ ~nvJronmenlol $1udJ¢$
SEPTEMBER 9 1983
JEANNIN ERHART
C/O 2702 GAMBLE
ANCHORAGE AK 99503
SELLER - BROWN BUYER - CAIN
SUBDIVISION - WILLIAMSON BLOCK - 1
LOT - 22
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 435 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME,
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 I8 ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
1200 ~JJcsl 33rd fiucnae, Suik B · Anchoeaq¢, Alaska 99503 · (907) 276-1361
R. C].int and Suzanne brown
SRA ~oc 80-I
Aritho.rage, AK 99507
Subjectg Lot 22, Block 1, Williamson Subdivision
Approval .tot thc individual sewcr and water facilities cannot
be granted until the Jlol].owing J. teJas have been completed:
~/'i']le septic tank pumped with a receipt submitted to '.his
o An adequacy test needs to be perJ~o]fmed on the existin9
leaching area. This test will determine if the syk;tcm is
ad~quate according to Natiollal Standalfds. A ].istin9 o2
needs to be submi'at(~d to this office ;{ior 01112 r(}VJ.i~V;.
Please notify this Depak"tment for a reinspection when th~:
noted discrepancies have bo(:n corrected. If there are any
further questions, please call this office at 264-,4720,
Sincerely,
AssisiLant EnvJ. roi-n;tental S[)ecialis{;
JRlO/ej/il2
INSPECTION APPOINTMENTS
'rIME TIME
--~-ATE DATE DATE
PEOTOR .NSPEOTOR ,NSPEO*O.¢rO_%X' )
MUNIcI~,LITy OF ,",h'C~ORAGE
~UfllCIPALITY OF ANCHORAGE L:,q. 0,' ,. ' '
ENVIRONMENTAL SANITATION DIVISION [J~'l' ~ ~ ~ '~"
Talephone 264-4720
BUYER PHONE
~REET LOCATION /f, v ( .
6. TYPE OF RESIDENCE ~-
~ One
~ SINGLE F .Y ~ Two
~ MULTIPLE FAMILY ~ Three
7, WATER SUPPLY
'~]~. INDIVIDUAL'
COMMUNITY
[] PUBLIC UTILITY
~IUMBER OF~BEDROOMS
Four
Five
Six
[] Other
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to tha't date, give wel
depth (attach log if available.)
8, SEWAGE DISPOSAL SYSTEM
'~ NDIVIDUAL~ON-SITE** /~'~ ? YEAR ON-SITE SYSTEM WAS INSTALLED·
[] PUBLIC UTI LITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED·
72-010 ,Rev. 6/79) ~,~F
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ,
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SlX
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
Coonection Verified __ INSTALLER
[]Septic Tank or []HoldingTank
Size: / (~.~)('~ If Tank is homemade SOILSRATING
give dimensions:
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
WELL TO:
I
Absorption1 Area to nearest Lot Line
5, COMMENTS
[~APPROV ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 (Rew 6/79)
November 6, 1981
R. Clin~Suzan Brown
% Terri Pisa
1577 C Street
Anchorage, Alaska 99501
Subject: Lot 22 Block 1 WJlliamson Subdivision
Approval for the individual, sewer and water' facilities
cannot be granted until the following items have been
completed:
(1)
The water analysis report needs to be submitted to
this office from the Chem Lab, 5633 B Street, for
our review.
(2)
The septic tank pumped with a receipt submitted to
this office.
If there are any further questions, please call this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
~ -' ~ -- DA~'E RECEIVED
INSPECTION APPOINTMENTS '~-~--'"'~= --~F~%L.¢~.L~.
TIME 'rIME TIME
~ATE DATE DATE
~UNICIPALi~
MUNICIPALITY OF ANCHORAGE ENVlRONM~;,,~[ ;,.j I'tcIION
825 L Street- Anchorage, Alaska 99501
8
ENVIRONMENTAL SANITATION DlVmSlONTelephone 264-4720 R ~C~/V~ D
FIEQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
~ PROPERTY OWNER . PHONE
~AIL[NG ADDRESS ~ '/
~ REALTOR/AGENT
~. LEGAL DESCRIPTION
STREET LOCATION
E. TYPE OF RESIDEI~CE
NLJMBEH OF~BEDROOMS
[] One [] Four [~] Other
[] SINGLE FAMILY [] Two I-~ Five
[] MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
~J INDJVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY since June 1975, For wells drilled prior to that date, give wel
[] PUBLIC UTI LITY depth (attach log if available.)
"~, SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE** ,/',~',? YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTEh THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] iNDIViDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection VeF[fied
Size: [~D~ If Tank is homemade SOILS RATING
§ire dimensions:
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/HoJding Tank Absorption/(~_~ Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[] APPROVED FOR .'"'~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY ~
72-010 (Rev, 6/79)