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HomeMy WebLinkAboutSAND LAKE #2 BLK 7 LT 24Onsite File SAmok Adh und Lake 2 Q� t 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: OSP211368 Work Type: Septic Upgrade Tax Code Number: 01113213000 Site Legal Address: SAND LAKE #2 BLK 7 LT 24 G:2224 Site Mailing Address: 5116 W 82ND AVE, Anchorage Owner: SMITH ROY P & MARIA L Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: �IV1Cnj o�C V n Lot Size in Sq Ft: Total Bedrooms: Department 11/2/2021 11/2/2022 6750 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 Received By: Date: Issued By: Date: II&A l 3 \ �icnS Municipality of Anchorage Uepantment P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV211095 COSA#: Permit#:OSP211368 PID#: 011-132-13 Legal Description: SAND LAKE #2 BILK 7 LT 24 Engineer: Garness Engineering Group Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the foundation has been approved. The approved separation distance is 9.5 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: Approved by: kez" Name of Reviper .........................................................1914.................... **** VARIAN C E/WAIVER REVIEW **** � {1 ra �� � ,t�� � s is Cr��" �f �� t n�1 :U I � s 6S ys b ..: _�� v° r n � �� 51 "s7 L � ii �1 � •� �' 3' - ---pp tz°—sus / a r Development Services Department Phone: 907-343-7904 On -Site Water 4: Wastewater Section ;=ax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 011-132-13 Property owner(s) ROY SMITH Day phone 907-240-6028 Mailing address 5116 WEST 82ND AVENUE ANCHORAGE, AK Site address 5116 WEST 82ND AVENUE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) SAND LAKE #2; BLOCK 7, LOT 24 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) x❑ Septic Tank Z Upgrade Q (w/wo ADU) (D) El Holding Tank ElRenewal ElDuplex Multiple 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. ( -�-" , , S -r P t 1A (Signature of property owner ',& authorized Permit/Rush Fees: _t595, Waiver Fees: 2 Date of Payment: 9 1 1a7 ,20 2% Date of Payment: Receipt Number: Receipt Number: Oil 3 y 1 G Permit No. CSS 19.2 Waiver No. 0!5 V 2I log 5 G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211368, Deb Wockenfuss, 11/02/21 ENGINEERING -SALES -CONSULTING,}: December 2, 2021 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Septic System Upgrade for Sand Lake #2; Block 7, Lot 24 To whom it may concern: During the installation of the proposed bed, it was noted that the drainfield could not be rebuilt 10' form the foundation. Per MOA records, the old bed was 15' wide and 6' from the foundation (extendp21 feet to the west, 6+15). During the excavation of the bed, it was found that native material was encountered about 19.5 feet off the west foundation wall of the house. Therefore, the new bed had to be installed in undisturbed material or 9.5 feet from the foundation. It was determined at that time that it would be best to rebuild towards the foundation. We are requesting that your department approve the variance of drainfield to foundation from 10 feet down to 9.5 feet. Justifications for granting this waiver are as follows: • The location of the water line is unknown. It seems reasonable that rebuilding the drainfield towards the foundation (where the current drainfield is located), has less potential to encroach upon the water line. • The original field has a variance down to 6.5 feet • We are only requesting a variance of 0.5 feet (10 feet required) • The proposed drainfield is a bed type drainfield, which utilizes bottom absorption. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, phase contact us at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineedng.com David Garness From: Deric Hart <alaska.aes@gmail.com> Sent: Wednesday, September 29, 2021 5:03 PM To: David Garness Cc: armservicesak@outlook.com Subject: 8222 Endicott St. Importance: High Follow Up Flag: Flag for follow up Flag Status: Completed David, This email is in refence to the requested water line locates for 8222 Endicott St. Attempting to located the water line for Sand Lake #2 BLK 7 LT23 was tried previously when a new septic was to be installed at 8231 Willcox St. Locating the water line for each home on the shared well for properties 8223 Wilcox St., 8231 Willcox St,. 5116 W82nd Ave. and 8222 Endicott St was the goal. I was able to pick up a signal heading to the east between both Wilcox properties until I broke the plane of the rear of those two homes. At that point my water line trace signal was overwhelmed by the utilities in the area that my transmitted signal had bled into which are far shallower than the water line. In order to do a water line trace it requires a completed circuit. Home to Home main water stub in connections or wellhead/water key to main water stub in of the home connection. All water lines are grounded to as per city code. Due to the grounding it potentially allows my trace signal to bleed into anything else that may be grounded. Most of the time a direct connection creates the path of least resistance and my transmitter only lights up the water line or creates the strongest signal. This was not the case for these four properties. I had signal bleed into everything grounded to the homes. I spent an extraordinary amount of time on this water locate project in attempt to sort though the stronger signals being picked up from the gas lines, cable lines, telephone lines and electric lines that had signal bleed over. Ultimately I was not able to confidently identify the water line location for any of the homes east of the rear of the Wilcox homes. I attempted individual home to home connections and well head to home connections in attempt to isolate each water line from the area utilities without success. I was very disappointed with the outcome but, after exhausting my best efforts I was not able to provide further information as to the exact location of the water lines for 8223 Wilcox St., 8231 Willcox St,. 5116 W 82nd Ave. and 8222 Endicott St. Please let me know if this provides a proper understanding of the locating situation. Thank you, Deric Hart Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211368, Deb Wockenfuss, 11/02/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211368, Deb Wockenfuss, 11/02/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211368, Deb Wockenfuss, 11/02/21 z u > � > K ros Z o I 133&1 S 11 OJIGN3 r, Z Ing 00053„££,7000N *^ Z 1 A (vni Hold 221 31 { _ i 'V t� town"r+sV�^ �NMN7YM 7NOJ 09 � � h 34 G - W z r zti c= X06 �> • • O'Q52Zo;v ti� QopOOVO� wzti�w`�oy hG � o,fo v Z z c pv . o 00053 ££.70 00 N Q m oD x o�0 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 4© Day of � P %/n��,� of 20 Z� , by and between ?0V ' 5.M 1 , 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. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as -SEPI 1 L S located at (legal description) 1-07- 2L ,) E LD4,-K- -7k 5 6 AID t - A KE �2- 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS 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 tern of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, c� repairs or permitted alterations to the system. 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 cll '� 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 accordance 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. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. 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. Jurisdiction: Choice 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 OWNER: By: 0�� (signature) P -H _(print name) STATE OF ALASKA ss. THIRD JUDICIAL DISTRICT The foregoing instrument was ackiiowledcyed before me this 20 by NOTARY PUBLIC FOR. ALASKA MyCommissionexpires: MUNICIPALITY: By: (signature) (print name) Date: "".�'day of Date: Title: f NOT ,4-r�- ::= y PUB F i� /111111\ (rev. 05/18/2018) Pace 3 of 3 ZD Municipality of Anchorage Page _ I of ~'~'-~ DEPARTMENT OF HEALTH AN[) HUMAN SFRVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 e Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~ ~__¢'~'_~0_'~) ~ ........... PID NDn~ber: ~_.~/.%.~- '~.t~ r Name: '~ALL~AIN, &~ ~ E ~ ~. _ Wastewater. System: D New ~pgrade Address: ~11~ ~ ¢¢~ ~_ ABSORPTION FIELD~r'r~ Phone:l~No of Bedrooms: .~~ ~ Deep Trench__~ Shallow Trench ~Bed DMound ~Other LEGAL DESCRIPTION _ S°ilRaling: ~ GPe/Sq. Ft ~i~ ' TOlal Depth from~ginal grade: Township: [ Range: ~ Secliou: Fill added above original gradm Gravel lengax I I WELL: D New ~ Upgrade G,a~o~ widex Numb~ol lines: IBistancebe[we~lines: Driller: Dale Drilled: Slalic water Level: Installer: Dale installed: I~J Yield:GPMII Pump Set at: FI.II Casing Height Above Ground:Ft. TANK SEPARATION DISTANCES ~ septic [~ Holding ~.T.E.P. Surface W~'6' J "A W& N/~ _ LIFT'STATION Foundation ,~ ¢ ~, 7,~- "Pump o~l~el at__~'mP ~';el at:_ I Hi,b waler alarm at: aemarks: BENCH MARK Inspections performed by: Dates: 1st .......................... 2nd_l~/,~ "* ~.. ~ . Department of Heal~ andHumaEServices approval ' ;~:-':'~?.x:: :~ '~, Reviewed and approved by: ~~ ~ __ Date://-~-% '~:: :'-:::: /-- / g , . 72-013 (Rev, 9/9i) MOA 25 SWING lIES: ~C 27 £~ BC. 9 AD 15.5 CD 24 CL£ANOUT BOTTOMLESS SANDF/LTEI? r--L_ MONITON 9 BENCH BOITOI/ 1250 GAL SfEP NO PERC. , CZASS C WELL ~Dl~ 150 FT 15 0 15 ,TO N *%t ~ ~..-,~ ............................ 45 60 75 90 SCALE; ~" ~ ~0 FL TOBBEN SPURKLAND P.E. 203 W 15TH. AVENUE ANCH. AK. 99501 LOT 24 BLOCK 7 SAN]) LAKE ~2 SAIJ TALLMAN 5118 P~ 82ND, AVE. SEPTIC SYSTEM AS BUILT DATE: NOV. 5, 1995 SHEET: 2/Z GRID: 222,l ?rom STEP 0,5 £t 1/16' holes every ~o f'eef botion oF a/rllne 6" Holfpipe 93034. 6' l. ono 3/4" PVC, HolDs Pointing Up Lateral and ON/flee Shield 95.; TOP VIE f 96, I ............................... ----CENF~L f~V[~ R~D SAND .................................... i+I 24 inches SIDE BEN£tt NABK DDTTDN SIMNG SDUflt WEST ASSUMED ELEV, 100.00 FT TOBBEN SPURKI_AND P,E. 205 W 15'FH. AVENUE ANCH. AK. 99501 _(.9 o 7 ~ 279-3~16 15x25 SAND FILTER LOT 24 BLOCK 7 SAND LAKE//2 SAW TALLk(AN I SEPTIC SYSTEM AS BUILT DATE: NOV. 5, 1995 SHEET: 3/3 GRID: 00~-4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 2 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950364 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:TALLMAN SAMUEL B & OWNER ADDRESS:5116 WEST 82ND AVENUE ANCHORAGE, ALASKA 99502 DATE ISSUED:10/25/95 EXPIRATION DATE:10/25/96 PARCEL ID:01113213 LEGAL DESCRIPTION: SAND LAKE #2 BLK 7 LT 24 LOT SIZE: 6750 (SQ. FT.) NUMBER OF BEDROOMS: 3 'PHIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 (18AACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL ].5 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1. ATTACHED MATERIAL SPECIFICATIONS AND CONSTRUCTION GUIDELINES (EXCEPT FOR THE FILTER SIZE, PERIMETER FRAMING AND LINER) MUST BE ADHERED 'PO. 2. AIR COMPRESSOR PUMP MUST BE LOCATED IN AN AREA OR ENCLOSURE SUCH THAT COLD AMBIENT AIR IS NOT INJECTED INTO THE FILTER. 3. INSTALLATION OF THE SAND FILTER BETWEEN OCTOBER 15 AND APRIL 15, OR ANYTIME AMBIENT TEMPERATURE IS LESS THAN 40 DEGREES F, MUST BE STARTED AMD COMPLETED ON THE SAME DAY OR THE SITE MUS'~BE TENTED AND HEATED TO PREVENT RECEIVED BY: ~.__._~/f / )/~ ~--~ ~/? ~----~ DATE: 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 24 BLOCK 7 SAND LAKE #2 SAM TALLMAN Lot too small for conventional system Install bottomless sand filter No. of Bedrooms 3 The east pontiou ofthis lot I~as up to 5 feet of fill placed over 5 feet on uatural silt. Sand Lake sand was fouud at 10 feet. This is too deep to be utilized effectively. The west portion of the lot does not have a fill. The material have a high perc rate, 1 inch per minute. The fact that the existing trench worked for 12 years shows that the soil will absorb waste water. The proposecl sandfilter will probably expose the existing trench and the material immediately adjacent to it. Any material coated with septic material will be removed fi'om site and replaced with Lake Otis Gravel. The only other option to the sandfilter is a holding tank. Public sewer is not in the planned in the foreseeable future. The installation of this septic system will not prevent wells fi'om be installed on the adjacent lots. There are no developed or natm'al surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. ::) ~o c,J Ll..I pg.1 ~4 vocont 13 I Lots P_IA I ~A ~ Qb I 49-th TOB,~EN SPURKLAND No. CE-~225 50 50 I00 150 200 ~-50 300 TOBBEN SPURKLAND P.E. I I 203 W 15TH, AVENUE ANCH, Al(. 99.501 LOT 24 BLOCK 7 SAND L~KE /~ SA~ TALLMAN 5'H6 W SZND. AVE, SEPTIC SYSTEM DESIGN DATE: SEPL 50, I005 SNEEI: 1/$ GRID: 2224 EXISTING TRENCH E~O REMOVE lOOO GAL TANK J NO PEt~C. [ I '1 15 0 15 A J~..~ ..................... ~,-,,v ~,,.,.~.. -.;; .................... ~:~' SCALE; = ~0 Fh TOBBEN SPURKLAND P.E. II 205 W 15TH. AVENUE ANCH. AK. 99501 ,~907'I LOT 24 BLOC/( 7 SAND IAIKE //2 SAM FALLUAN 5116 W 82ND, AVE. SEPTIC SYSTEM DESIGN DATE: SEPL 50, 1005 SHEET: 2/5 GRID: 2224 3/4' AIR EDMPRESSgR From STEP Tank 15 holes every 2 Peel ~ aexf hoftom o£ airline Hal/pipe D3034, 6' Long pvc, Ho/o, Poi,,i,9 u~ Lateral and Ortih'ce Shield TOP VIE~f 3 FEET ~' ~VE£ ,ooooooo'O°O%~O°O°O~o%;°g°g°g°g°g°o°o'o ,oooooo(,oo SIDE VIEIf BENCH NARK ASSUMED ELEV, lDO. O0 F1 TOBBEN SPURKLAND P.E. J 20.3 W 15TH. AVENUE ANCH. AK. 99501 15x25 SAND FILTER LOT 24 BLOCK 7 SAND LAKE ZY2 SAkl TALLMAN J J SEPTIC SYSTEM DESIGN DATE: SEPT. 50, 1995 SHEET: 3/3 GRID: 2~c~4 Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SFRVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMEC FOR: 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15 16 17 18 19 20 COMMENTS CATE PER FORMEC: Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER EN~ OUNTERED? IF YES, AT WHAT O DEPTH? p E ~oni(oring? D~le: _ Reading Date Gross Net Cepth to Net Time Time Water Crop PERCOLATION RATE "~ - (minutes/inch) PERC HOLE DIAMETER -- TEST RUN BETWEEN "~ FT AND ~./.~/~_ FT CERTIFY THAT THiS TEST WAS PERFORMEC IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. CATE; ~,'~ ,,~,~ ,~'~_~'~ 72-008 (Rev, 4~85) ~ ~ PERFORMED FOR: TI-t- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION:_~L..~'J~ ~.~/J/ ~'~'] ~)..¢,~p.~L.~.~4 Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE COMMENTS WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT 0 DEPTH? p E SITE PLAN PERFORMED BY: GUIDELINE8 IN EFFECT ON THIS DATE. DATE; ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-008 (Rev. 4/85) PERCOLATION RATE (mJnules/~nch) PERC HOLE DIAMETER __ TEST RUN BETWEEN __ FTAND __ET CERTIFY THAT THIS TEST WAS PERFORMED IN Reading Date Gross Net Depth to Net Timo Time Water Drop 15 PVC, Holes Pointing Up TOP VIEW Lolerol and Orlifice Shield 49Lb 9~.1 AMOCO 4545 PAVING ROAD SAND 88. £ SIDE VIEW BENCNI~RK BDTTDM SIDING SDUTH WE'ST CDBN£~ ASSUMED ELEV. lOO. O0 FT, TOBBEN SPURKLAND P.E. 20.5 W 15TH. AVENUE ANCH. AK. 99501 (907/ 279-~916 15x25 SAND FILTER LOT 24 BLOCK 7 SAND LAKE //2 SAki TALLkiAN SEPTIC SYSTEM AS BUILT DATE: NOV. 5, 1995 SHEET: 3/3 GRID: RB¢4 NOV 20 ~95 1~:~6 MUNI OMBUDSMAN P.1/I INVOICE ~UBOIVIStON ........ ORDER DESCRIPTION AMOUNT ~'~-'~'~ .'"~_7' -' , ---' . ~'~,~' ~,~,"~.~,A-~ ~-. . - .- - ............ ~ ' ~.~.~ .... ~ ...... ~', ~ /) ~.(/ } .......... ~..~ ~ F:. ~~L~ ........ ~,,_ -+ .... ......... ~~ ...... Post-it'Fax Note 7e71 I_ . .~- Fl~c,r~: : :~EF~tq l-:onst, D~,,, PHOHE I'lo, : Nov, 17 1995 :J- ', 50PH :i'J!~PECT:i:ONS:: (90'?) 563-3464. .[HCI]~t?~AT.[Oi'.!: (')07) 786-85! YP~: 0~ INSPEC].'IOH: /],WILL REiEXAH]:NE AT NEX'f' IN.:,cc,(,l,;J. tlN [: ] 1:10 NOT {,HN[,aAL IJNr[']:L T.SPURKLAND P.E, 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Enviromnental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 November 17, 1995 Subject: Gentlemen; Parcel Id 011-132-13 Lot 24, Block 7, Sand Lake #2 Building Setback Waiver This lot, as are all the lots in Sand Lake S/D, is ve~ small: 135 ft x 50 ft. The area available for the installation of this waste water disposal system is at the west portion of the lot. This available area, based on set backs from buildings and lot lines is 30 ft.x 15 ft. which is not sufficient for the proposed installation without encroachment of west lot line or the building. This fact should have recognized during design and review, but was overlooked by the designer. It was recognized during construction and it was decided to encroach on the building instead of the west lot line which also would include a easement encroachment. This residence is of a standard construction with a four foot crawl space below the first floor. The footing is approximately 4 feet below existing ground level. The bottom of the sand filter is 6 feet below ground level, two feet below the footing. Assuming a 30 degree pressure distribution below the footing, the soil pressure of the footing does not extend into the filter, the spread at 30 degrees and two feet depth is 1.2 feet, a safe distance away fi'om the filter. The back fill on the wall was not affected by the excavation. 6 feet of undisturbed soil separated the excavation from the wall. The effluent from the filter is discharged 2 feet below the footing. The effluent will not flow laterally or up thi'ough the soil. Surfacing of effluent in the crawl space is not a concern. There is no compromise of safety or health associated with this installation. Yours Tobben 80burkland P.E. T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: Parcel Id 011-132-13 Lot 24, Block 7, Sand Lake #2 Lot Line Waiver November 17, 1995 Gentlemen; This lot, as are all the lots in Sand Lake S/D, is ve~ small: 135 ftx 50 iL The m'ea available for the installation of this waste water disposal system is at the west portion of the lot. This available area, based on set backs fi'om buildings and lot lines is 30 ft.x 15 ft. which is not sufficient for the proposed installation without encroachment of some of the lot lines setbacks. This fact should have recognized during design and review, but was overlooked by the designer. It was recognized during construction and it was decided to encroach on the fi'ont lot line, since encroachment at this location would uot have any impact on other private land. This encroactunent of 4 feet does not constitute a health or safety hazard. The effluent of this disposal system is of secondary treatment quality and the discharge to natural soils is 5 feet ore more below street grade. There are no road ditches where this effluent may surface. Yours Tobbent/Spurkland P.E. Rick Mystrom. Mayor Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 November 21, 1995 Tobben Spurkland, P.E. 203 West 15th Avenue #203 Anchorage, Alaska 99501 Subject: Waiver Request for Lot 24 Block 7 Sand Lake ~2 Waiver Request #WR950063, ~011-132-13, SW950364 Dear Mr. Spurkland: Your request for a waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 5 feet from the north property line. This approval applies to 'the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. ~s~C/ro~sscerely' gram Manag On-site Services JC/ljm MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ t~z~_~ PID~ 011-132-13 HA~ ~O~ Date Received: November 6~ [[995 Legal Descriptzon: Lot 24 Block 7 Sand Lake #2 Engineer: Tobben Spurk]_and, P.E. 203 West 15th Avenue, ~203 Anchorage, Alaska 99501 Applicant: Sam Tsllman Waiver Requested: Lot line waiver of 5 feet to the north property line. Criteria: ]. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: Points: 3. Other: Waiver List Conditions or Date zs Granted: __~__ Waiver is NOT Granted: Reasons for above: By: ow Rec ~: #01452/3950 Amount: S 115.00 Date Paid: Nov 6, 1995 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~IEW T TAIq "THoHPSoN ~UPGRAOE NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION J DISTANCETO' ~ Manufacturer -- J J~O IiF HOMEMADE: k.l& Absorption area Inside length Dwelling NO. OF BEDROOMS PERMIT NO, Liquid depth DISTANCE TO: Iwell PERMIT NO. J Material Liquid capacitv in gallons DISTANCE TO: Class DISTANCE TO: DISTANCE TO: JWell /~ .~ No. of lines/J-Length of~(Deach line Top of tile to finish grade Width Nearest lot line Trench width Foundation Total len~ nos Material beneath tile Depth Crib depth Building foundation Driller Sewer line PERMI NO. Total ef fec~..~b~rption area inches PERMIT NO. Crib diam0tor Total effective absorption area Well Nearest lot lino Depth Distance to lot fine PERMIT NO. Building foundation Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS LEGAL [b,.~ E L_ L Eli ~'-4 F'ERNI'f' NO. ,' F'.='=-'='"¢'_,=.E.lgl,_,_:. ) HFFL] -.~N r LOCRT I ON I._EGflL .~,~li"l~"R JEFIN TFIOMF'SON L~-.. B,.' SRND LFIKE ~2 t"IR:qIMUFI I~_ItlEEF:. OF E, EEF..UL[fI_ = 3: TI4E REg!UIREE:, _,I~.E OF THE: '-. ..,UIL RE-,uRF] Iufl '-"c :, T_,TEII I.:,. 7'FIE LENGTFI DIMENSION IS THE LENG'FH (IN FEET) OF 7'FIE TRENCH OR DRRINFIEL.[:'. THE DEPTH OF R TRENCH OR PIT IS THE DISTFINCE BETI.4EEN TF'tE SUF.'.FFICE OF THE GROUI".ID FIN[;:, THE BOT'f'OM OF 'THE E,%'CRVRTION (IN FEET). THERE IS NO SET NIDTH FOR TRENCHES. THE GRFIVEL I]:'EP]"N IS THE MINtNI.JM DEPTFt OF GRRVEL E:E]THEEN THE OLITFFILL PIPE FIND THE BOTTOH OF THE E,'.':',CFI',,,'RTION (IN FEET). -,= -'=.- ,- -, .-u FHI_, [:,EF'RRTMENT [:,URING TFIE F'ERNIT FIF'F'LIC:FINT NH_, THE F.E.~,FuI~=,I[,IL.I] r TO INFORM ' "= .I.N_,II-LLH1 IuN tN=FP-b]iLd~L-, OF RN"r' HLLL:, RE:'JFICENT TO 1FI] .... FF..FEF. t~ FINE:, THE NI.JHEEF:. OF RESI[:'ENCES THFIT TNE HELL HILL _,EF..,E. E,~_.F..FILLIN~ OF FIN"r' _,T_,FEll t.,JITHOI.IT FINRL IN_FEL. TIuN RN[:' HFFK_ HL. iblI_ E:,EF'RRTMENT HILl_ E,E SUE:JECT TO IRLL.,EL. UTILN. MINIHUM E:,ISTRNCE BETNEEN R NELL RND RN'¢ ON-SITE SEFIRGE DISPOSRL S'.?STEM IS tE~8 FEET FOR R F'RIVRTE NELL OR t5~ TO 28E~ FEET FROM R PUBLIC HELL. DEPENDING UPON THE ]%.'PE OF PUBLIC NELL MII'4IMUI'fl [:,ISTRNCE F'RON R F'RIVBTE NELL TO R PRIVRTE SEHER LINE IS 25 FEET TO R COHI','IUNIT'¢ SEI.,IER LINE IS 75 FEET. HELL. LOGS RRE RE]ZgJIRED RND HUS'F BE RETURNED TO THE DEPRRTHENT I.,JITHIN ]:el g,R't'S OF THE NELL COMPLETION. OTNER REQUIREMENTS I'"IR'~' RF'F'L'¢. SPECIFICRTIONS RND CONSTRUCTION DIFIGRRI"IS RRE FP/RIL. FIBLE 7'0 INSURE PROPER INSTRLLRTION. F f..:F-.! I 'Z ]- E:::---:[) :[ t ..[ .... [:,EC:EF"-iE:EF;~: --=::::L.. _IL::'" ..... ~. I CERTIF'¢ THRT t.: I FIH FRI',IlLIRR HITH THE REQUIREMENTS FOR ON-SITE SEP.IERS RND HELLS RS SET FORTH B'¢ TFIE I"/UNICIPFILIT'¢ OF RNCHORRGE. 2: I 1.4ILL INSTRLL THE SYSTEM IN RCCORE:,RNCE NITN TNE CODES. 2:: I UNE)ERSTRND THRT THE ON-SITE SEHER SYSTEM t,'lR'¢ REQUIRE ENLRRGEMEN]' IF TFIE RESIDENCE IS REI',lO[:,E~Z:, TO INCLU[:,E NORE THRN Z~ 13EE:,ROOMS. // F, FFLI,::F, NT/.EI"~R...X...~ERN TH,:,f'IPSON ~ ':' ANCh()NA~i[ ,', , <., 3i5()? ,.~:~ ., !',,d / ,~ (90 ,': /64-4 ! I ' <Permit ~: 821129 January 3]., 1983 TO: Permit App l~icant Subject: Lot ~ Block 7 Sand Lake Subdivision #2 A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerely Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 PERMIT NO. I'"lUN Z C: .f., F..'IL I' -I"%-" OF DEPRRTMENT OF HERLTFI RND ENVIRONt,'IENTRL F'ROTECTION 825 "L'" STREET., FtNCWORRGE, FIK. 99501 264-4720 l,-J EIb C. BP-IF:. C,N---S :£ ']rE 821129 ) RPPL I CFINT LOCRT I ON LEGRL EMMR JEFtN THOMPSON L2~_, B? SRND L. FtKE ~2 T~r'F'E OF SOIL RBSORP'FION S"r'STEM I':i;: 22ti E NORTHERN LIGHTS LOT SIZE TRENCH 27'9-8486 SQURRE F'"EET MRXIMUM NUMEFER OF BEDROOMS SOIL RFITING .::SQ FT/BR)= 150 THE REQUIRED SIZE OF' THE SOIL RB'::]ORF'TION S'YSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF FI TRENCH OR. PIT IS THE DI_~;TRNC:E BETWEEN 'THIS SI.JRFRCE OF THE GROUND Ii'tN[:' TME BOTTOM OF THE E',¢,CI=IVRTION (IN FEET). TNERE IS NO SET WIDTH FOR TRENCHES. THE GRFIVEL [:,EPTH IS TME MINIMUM DEPTH OF GRRVEL BETNEEN THE OUTFRLL PIPE RND ]"FIE BOTTOM OF THE EXCRVRTION (IN FEET). PERMIT RPF'LICFINT HRS THE RESPONSIBILIT"r' 'FO INFORM THIS DEPRRTMENT [:,URING TME INSTFILLRTION INSPECTIONS OF' RMY WELLS RDJ8CEN'F 'FO THIS PROPERTY FIND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. BFICKFILI_ING OF RN'-r' S'¢STEM WITMOUT FINRL INSPEC'I'ION RND FIPPROMRL B'¢ THIS DEPRRTMENT WILL BE SUBJECT 'fO PROSECUTION. MINIblUM DISTRNCE BETHEEN FI WEL. L RND FINY ON-SITE SEWRGE I)ISPOSRL S'-r'STEM IS :1.00 FEET FOR R PRIVRTE NELl.~ OR 150 TO 200 FEET I--ROM R PUBLIC WELL DEF'ENI}ING UPON THE T'¢PE OF PUBLIC WELL MINIMUM DI2~]TR~.,ICE FROM B PRIVRTE WELL. TO R PRIVRTE SEWER LINE IS 25 FEET RND 'FO R COMMLINIT~' '-.-';EWER LINE IS 75 FEET. WELL LOGS FIRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITH;tN ~0 DF¢¢S OF' ]"HE WELL. r:OMPLETION. OTHER REQUIREMENTS MR"r' I~PPL"r'. SPECIFICRTIONS FIND CONSTRUCTION DIBGRRMS FIRE RVFtILFIBLE TO INSURE PR. OPER INSTRLLRTION. I CERTIFb' TI4FtT 1: IRM FRMILIFIR WITH TilE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS RS SET FORTW B~r' THE MUNICIPFtLIT"r' OF RNCHORRGE. 2: I WILL INS]'RLL THIS S'¢STEM IN FtCCOR[:,FINCE WITH THE CODES. :~: I UNDERSTFIND THR"r THE ON-SITE SEWER S~.r'STEM r,IR~/ REOUIRE ENLRRGEMENT IF-" ]'HE RESI[:,ENC:E IS REMODELED TO INCI.tJ[)E MORE THFtN _..S..~ BEDROOMS. SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PFRCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAl_ DESCRIPTION: L~ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SILT' SITE PLAN ',ASG,O ND ATER ENOODNTERED? .NO [ 0 P E IF YES, AT WHAT DEPTH? Readin9 Date Gross Net Depth to Net Timo Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ---- FT COMMENTS PERFORMED BY: 72-008 [6/79) CERTIFIEDBY: ~¢~7'~ ~.~ DATE: CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL 0ONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT · -:, Plans for the construction of , · .. -' ; x - ' . :¢ ..... . .... public water system located ' · ~ Alaska, submitted in accordance with ~8 AAC 80.J00 ~. x ,. r~k ~-'a ~ m"('. ~have been reviewed and are approved. /'~ conditionally approved (see attached conditions). / C~'~.::':~ . ,/? ;"" , ~ ,,',. /- ... If construc[ion has not started within two years of the approval date, this certificate is void and new plans ~nd specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAl.. TO OPERATE The construction of the ', ,'4 hi ,-: (' .4? V ': / :.: ~'. k'! ,.. /"~ water system was completed on ":; - '" '? ~ " .(date). The system is hereby granted interim approval to operate for 90 days following the cpmpletion date. BY TITLE DATE As-built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. 7,, .. ....... ' ,. .r..., ..'/. 1" / ,~l I/-' '~/ ~,',.: 0 0 0 .)! 0 ¢ Q 0 0 0 f& 0 · 0 0 0 0 0 Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL.TH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete lega-I description _ Location (site address or directions) Day phone Day phone Property owner Mailing address Lending agency Mailin. g address Agent '~J D'c~.~,t~l~.t-. ~ ~¢,'YA, ~O~A Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev. 1/91) Front MOA#21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water - supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm '-~J¢-~ ~1~¢'[~'~1-¢t~,~J¢ '~-~- Phone '3'"7'~-3'°1)L¢ Address ~.O~ i.¢-' 1~'/.-~ /~ ~o L~ EngineeCs signature DHH8 SIGNATURE /~ Approved for Disapproved. T/~/,'~ E~ bedrooms. Conditional approval for Date .. b/¢¢'/'i '~ bedrooms, with th-e following stipulations: 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 DHHS does this as a courtesy to pumhasers 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. Municipality of Anchorage JUL 0 2 ]999 ¢, DI=PARTMENT OF HEALTH & FIUMAN oEJ~0~i~Tv OF ^NC~U~^O~ Environmental Services DivisioI~NVIRONMEN~'AL SERVICES 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checldist LegalDescription:_~O'T~-~i BV.'7~ ~ANIJLA?._~'~.ParcelI.D.: ~-)[I- ~,.~- ~'~ A. WELL DATA Well type __ If A, B, or C, attach ADEC letter. ADEC water system number ~ / ~,~- / / _ Log present(Y/N) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) Wires propeny protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well productien g.p.m, g.p.m. WATER SAMPLE REStJLTS: Colifom,/J/~ _Nitrate Date of sample: _ ~/,¢<¢' ,/'~ ~'t Collected by: Other bacteria _ B. BEPT1CIHOLDING TANK DATA Date installed lO 5- _ Tank size Foundation cleanout (Y/N) _ D~te of Pumping. ~/~ C. ABSORPTION FIELD DATA Date installed )_~ O Number of Compartments ~Cleanouts (Y/N) . Depression (Y/N) P"[ H gh water alarm [Y/N) "/ _ umper Length ¢¢-- ~' Width _ Scil rating (g.p.d./ft= or fl~/bdrm), ,l/ _ System type ~'~ '/'/'~"~/'¢ ~"¢ ! 5' Gravel thickness below ~)ipe ~ "_ Total dspth _ ~ ~ _ Effective absorption area Date of adequacy test. ~/¢?/¢ ~ Results(Pass/Fail)_ -~ For Fluid depth in absorption field before tsst (in.); _ '~r'~/_ mmediately after//',~¢ gal. Fluid depth ~ (ins) Minutes later: ~/ Absorption rate = Peroxide treatment (past 12 months) (Y/N) I"'l I:) If yes, give date Monitoring Tube present (Y/N) 7 - Depression over field (Y/N) I~ ~ .bedrooms water added (in.): _ ~ y,.~ 0 g.p.d. / t/ 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) ""'/ High water alarm level at* Cycles tested Size in gallons ,/r~3_ ~- O "Pump on" level at* ~ ~/ "Pump off" level at* *Datum / Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT T/ Septic/holding tank on lot SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ ~' Property line 1 6) Absorption field. Water main/service line t 0 Surface wateddrainage ' '/,A- On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ,~ Surface water pt/./,& Curtain drain 1-4 IA F. ENGINEER'S CERTIFICATION Building foundation Driveway, parking/vehicle storage area Wells on adjacent lots ) (2 Water main/service line 7/I) I certify that I have determined thru field inspections and revie~ in conformance with MOA HAA guidelines in effect on this date. Engineer's Name ~-'~ ~'~ ~ Date are HAA Fee $ Date of Payment Receipt N u tuber ~-v~Z ¢~'~' 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGF DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services Qn-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I,D. # 1. GENERAL INFORMATION Complete I~gal description j~LITY OF ANCHOI~~' ElemeNTAL SERVICES DIVISION H0V 0G .1995 RECEIVED Location (site address or directions) Property owner_ J AI_LF/A/~! i Mailing.address ¢--~Jl~ [~ ~ ~ · Lending agency Day phone Day phone Mailing__ address ' Address . .. ·, . Public water NOTE: " ~ lng rD the legality and status of system. ' 4:!irTYPE OF WASTE~ATER DISPOSAL: ~lndividual on-site . ~ . ~[ ~rJ Holding tank '": ' ' - _ community on-site - If community well system, provide written ,confirmation from State ADEC attest- If community wasfewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-025 (Rev, 1/91) Fronl 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 tbs information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Address ~) Engineer's signature __ DHHS..Si61NATURE , '//? Approved for ::~ , bedrooms. Disapproved. bedrooms, with the following st pu ations: _ Conditional .approval for Additional Comments ::'The M~i:c ~' ty of ,~(~rage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificate~,based only upon the representat ons g yen in paragraph 5 above by an independent professionai'engi ,n e,,? registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and {nei~ lending institutions in orderto 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(ROy. l/St) Back MOA~I Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street. Room 502 ® Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist WELL DATA Well type It ir A. B. or C. attach ADEC ~ottor. ADEC water ~ysteu, uambor ,g /b~/! Log prcscut (Y/N) Date completed Total depth __ Cased to Casieg height (above ground) _ Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Collected by: ~ 5~ B. SEPTIC/HOLDING TANK DATA Date iustalled q 0' Tank size } ~9.-I:,3(e¢ Number of Compartments ~ _ Cleanmfls (Y~ Fmmdation cleanout (Y~) __~_ Dcprcssiou (Y~) ~q High water alarm (Y~) ~ Date of Pmnpiug _ ~ Pumper ~//~ ABSORPTION FIELD DATA Date installed t 0/'30/cia Lenglh c,0.. {9~ Width Effective absorptioa area ,~ Date of adequacy test Fhfid depth in absorpfiou field before test (iu3: Fhfid depth_ ~ (ins.) Minotcs later: Peroxide treatmeat ,past 12 mouths) (Y~) Soilranng tg.p.d./ft2orft2POdrln) // _Systcmtype Gravel thickaess below pipe. [0 Total depth la t Mouitoricg Tube present(Y/N)4]__ Depressiou over field (Y/N) Results (Pass/Fail) "~'~ ! For ..~> bedrooms /~/t~- hmnediately after I~gal. water added (in.): J Absorpttou rate = / .g.p.d. I'~'/ If yes, give date LIFT STATION Date installed '0/~7 ]q~" Manhole/Access (Y/N) 7 High water alarm level at* Cycles tested .~ Size in gallons "Pump on" level tit* 1'/q *Dat. m E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELLS~i~I~ TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line "Pump off' level at* t7/Z._ MIJNICIPALI'tY OF ANCHo~- I~NVIRONMI~NTAL SI~RVICE$ DIVISION ; On adjacent lots ; On adjacent lots Pnblic sewer manhole/cleanont I Lift station t ~ ~,~ llOV OG 1996 RECEIVED SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Bnilding foondation 7~, ~' l' Property line ~ 0 t * Absorption field ..~ Water lnaitffservice line ' I0 I Snr£ace water/drainage I'"'//~,. Wells on adjacent lots I ~..~ [ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Bnilding fonndation Surface water Curtain drain / Water mailUservice line ~> / ~.) Driveway, parking/vehicle storage area ~ ~ Wells on adjacent lots x [~ ~ I Property line ENGINEER'S CERTIFICATION ./: T ~ · I certtf~ that I have deternlined thrufield inspections and review of M'unicipal record½, tha:A'the.above systems are Date HAA Fee $ o-~' ~ Waiver Fee $ //~7 Dnte of Payment Receipt Nnmber Rev. 8/95 eSS: haa.wk.doc Date of Payment ///¢/t~ ~--e''''''- Receipt Nulnber t/.~ O~e~y T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: HAA Lot 24, Block 7 Sand Lake #2 Lot Line Waiver Gentlemen; November 6, 1995 The septic system installed on this lot on October 30, 1995 encroached on the ten foot setback fi'om the north prope~Xy line. We request a lot line waiver to 5 feet. Due to the size of the lot it was impossible to install the proposed system without encroaching on one of the lot lines. Yours Tobben Sl~urkland P.E. HOV IE, '95 8'_~: EM REHRX PF'i_-iPED-fIES; F'F'::,::E, Ei P. 2 50' (RE6) 0 50' (RE(;) 5 C) ~0 30 Pl CO '~t~ CT&E EnvironmentaIServiceslnc. CT&E Ref.~ 95.5009-3 Matrix WATER Client Sample ID L24 BLK7 S~/~D LA/<E ~2 Client Name TOBBEN SPURKI~ND, P.E. WORK Order 19528 Ordered By Printed Date 11/10/95 · 15:49 hrs. Project Name Collected Date 11/06/95 ~ hrs. Project~ Received Date 11/07/95 ~ 08:00 hrs. PWSID UA Technical Director STEPHEN C. EDE Sample Remarks: SFlqPLE COLLECTED BY: T.S. QC Allowable Ext. knal Parameter Results Qual Units Method Limits Date Date Init Nitrate-N 0.10 U mg/L EPA 353.2 10. 11/08/95 CMR See Special Instructions kbove UA = Unavailable See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than APPLIC..NT FILLS OUT UPPER HAL ONLY PropeHyOwner Emma Jean Thompson/Bruce J. Kiessling 2211 E. Northern Lgts. Blvd., Anchorage, Ak. mpCode 99504 IPhone 279-8486 Mailing Address Buyer Address Samuel l'allman lO11W. 30th, Anchorage, Ak. Zip Code 99503 Lending Institution Address First National Bank 201 W. 36th, Anchorage, Ak. Realty Do, & Agent Address Legal Description Street Location Dynamic Realty - Janies ltufi;man 501 W, ~'l;hern Lgts., Anchorage, Ak. 8212 Endicott ~ .Z Type of Residence  Single Family \ 3 Multiple Family 'TMNo. of Bedrooms Water Supply Public Utility Sewer Disposal [~ Individual [] Public Utility [] Holding Tank Zip Code Zip Code 99503 99503 Phone 276-6300 Phone 279-7611 ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Io9 if available). Year Individual Installed: 1 9B~ When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Date Inspector Field Notes: Time [)ate Insp6ctor Time Date Inspector Time Date Inspector MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONM~NYAL PROTECTION RECEIVED (. '¢') APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' *CONDITIONS OF APPROVAL Soils Rating Date Sewer Installed Well TO Absorption Area Well to Tank Well Log Received Septic Tank Size f (~) C) ('~)~ 72023